{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:21:45Z","timestamp":1788261705841,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2008,1,22]],"date-time":"2008-01-22T00:00:00Z","timestamp":1200960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to compare the operative results in regard to reducing anastomotic leakage and stricture formation using a newly designed layered manual esophagogastric anastomosis versus a stapler esophagogastrostomy versus the conventional hand\u2010sewn whole\u2010layer anastomosis after resection for esophageal or gastric cardiac carcinoma. From January 2004 to September 2006, a total of 1024 patients with esophageal or gastric cardia carcinoma underwent a layered esophagogastric anastomosis with the assistance of a three\u2010leaf clipper in a single university medical center. The mucosal layers of the esophagus and stomach were sutured continuously with 4\/0 Vicryl plus antibacterial suture (polyglyconate). From May 2002 to December 2003, there were also 170 patients and 69 patients who underwent stapler and conventional whole\u2010layer anastomosis, respectively; they served as control groups. The results were analyzed retrospectively. The operative mortality rate was 0.7% in the layered group compared to 5.9% and 7.2% for the stapler group and the whole\u2010layer group (<jats:italic>p<\/jats:italic> &lt; 0.01), The anastomotic leakage rates were 0%, 3.5%, and 5.8% for the layered group, stapler group, and whole\u2010layer group, respectively (<jats:italic>p<\/jats:italic> &lt; 0.01). All patients were followed postoperatively. Six patients in the layered group (0.6%) developed mild stricture formation compared to 16 patients in stapled group (9.9%) and 5 patients in the conventional whole\u2010layer group (7.8%) (<jats:italic>p<\/jats:italic> &lt; 0.01). The application of layered esophagogastric anastomosis could reduce the incidence of anastomotic leakage and stricture after esophagectomy compared with the stapler and whole\u2010layer manual anastomoses. It is easy to apply and could be used as an alternative for esophagogastric anastomosis after resection for esophageal or cardiac carcinoma.<\/jats:p>","DOI":"10.1007\/s00268-007-9396-5","type":"journal-article","created":{"date-parts":[[2008,1,21]],"date-time":"2008-01-21T21:43:06Z","timestamp":1200951786000},"page":"583-588","source":"Crossref","is-referenced-by-count":22,"title":["Clinical Application of Layered Anastomosis During Esophagogastrostomy"],"prefix":"10.1002","volume":"32","author":[{"given":"Zi\u2010Jiang","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West China Hospital Sichuan University 37 Guoxuexiang 610041 Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Fan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West China Hospital Sichuan University 37 Guoxuexiang 610041 Chengdu Sichuan 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Surgery, West China Hospital Sichuan University 37 Guoxuexiang 610041 Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Li","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West China Hospital Sichuan University 37 Guoxuexiang 610041 Chengdu Sichuan 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