Comparative Study between Linear and Circular Stappling in Esophago-Jejunostomy after Total Gastrectomy Surgeries

Background Gastric resection, often required for gastric cancer and other indications, remains a complex surgical procedure with significant risk of postoperative complications that can negatively impact patient outcomes and quality of life. Purpose compare the short-term outcomes of esophago-jejunal anastomosis using the linear stapler versus circular stapler in restoring gastrointestinal tract continuity after total gastrectomy surgery. Patients and Methods This prospective study involved 64 patients undergoing total gastrectomy, who were randomly assigned to either the linear stapler (LS, n=32) or circular stapler (CS, n=32) groups. Preoperative assessments included comprehensive clinical evaluations, laboratory tests, and imaging studies. The surgical procedures were performed laparoscopically or via open techniques, with detailed monitoring of operative times, anastomosis times, and postoperative complications. Results The LS group demonstrated significantly shorter operative time (231.53±27.47 minutes vs. 280.75±36.79 minutes, P < 0.001) and anastomosis time (31.22±3.84 minutes vs. 36.06±7.78 minutes, P=0.002). The postoperative hospital stay was shorter in the LS group (10.1±3.25 days vs. 13.38±6.19 days, P=0.025). Anastomotic stricture occurred exclusively in the CS group (18.8%, P=0.024), and leakage was more prevalent in the CS group (25.0%) compared to the LS group (3.1%, P=0.026) while postoperative reflux was more prevalent in the LS group. Conclusion The linear stapler technique for esophagojejunostomy after total gastrectomy is associated with improved short-term outcomes compared to the circular stapler technique.