Comparison of Postoperative Outcomes of Hand-Sewn Versus Stapled Esophago-Jejunal Anastomosis during Total Gastrectomy

Introduction: The optimal technique for esophagojejunal anastomosis following total gastrectomy remainsdebated.Aim of work: This study compares perioperative outcomes and postoperative complications between stapled andhand-sewn anastomosis techniques.Patients and methods: A retrospective cohort study was conducted on 102 patients who underwentesophagojejunal anastomosis after total gastrectomy. Patients were divided into two groups: stapled anastomosis(n = 44) and hand-sewn anastomosis (n = 58). Key parameters analyzed included operative time, intraoperativeblood loss, hospital stay duration, time to oral intake, postoperative complications (leakage, stricture, infection),recurrence, and mortality. Statistical comparisons were performed to assess significant differences.Results: Stapled anastomosis was associated with significantly shorter operative time (180.2 ± 14.8 vs. 230.4 ±8.6 minutes, p < 0.05) and reduced intraoperative blood loss (170.3 ± X vs. 240.4 ± X mL, p < 0.05). Hospital staywas shorter in the stapled group (10–13 vs. 15–18 days, p < 0.05), and oral feeding was initiated earlier (7–9 vs.9–11 days, p < 0.05). No significant differences were observed in anastomotic leaks, infections, or pneumonia. Aslightly higher, though non-significant, rate of anastomotic stricture was noted in the stapled group. Mortality andrecurrence rates were comparable between groups.Conclusion: Stapled esophagojejunal anastomosis offers advantages in operative time, blood loss, and recoverywithout increasing major complications. Despite a non-significant rise in stricture rates, overall outcomes supportits use in clinical practice. Further randomized studies are warranted to validate long-term oncologic safety.