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Numerous techniques for anastomosis fashioning have been described, including hand-sewn (HS) and stapled (ST) anastomosis however, the optimal method remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Analyse short-term outcomes for ST vs. HS anastomosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried. Primary outcomes were anastomotic leak (AL) and stricture (AS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve RCTs (2015 patients) were included. All trials were deemed to have an intermediate risk of bias. ST anastomosis was performed in 51.9%. The age of the patient population ranged from 37 to 88 years and 73% were males. Squamous cell carcinoma was diagnosed in 76.9% of patients. Neoadjuvant therapy was completed in 32.9%. Ivor-Lewis or McKeown esophagectomy were performed with thoracic (57.2%) or cervical (42.8%) anastomosis. No significant differences were found for ST vs. HS anastomosis for AL (RR 0.97; 95% CI 0.70\u20131.35) and AS (RR 1.47; 95% CI 0.96\u20132.23). Further, no differences were found for cardiovascular complications (RR 1.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.59), pulmonary complication (RR 1.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.28), length of stay (SMD 0.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69), and 30-day mortality (RR 1.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18). Operative time was shorter in ST anastomosis (SMD \u2212\u20090.11;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ST and HS esophagogastric anastomosis yield comparable rates of AL, AS, postoperative complications, and in-hospital mortality. The use of ST anastomosis may result in a shorter operative time. The choice of technique should be determined by the surgeon\u2019s expertise and clinical scenario.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13304-025-02464-y","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:33:48Z","timestamp":1763703228000},"page":"95-106","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stapled vs. hand-sewn anastomosis during esophagectomy: a randomized trials systematic review and meta-analysis"],"prefix":"10.1007","volume":"78","author":[{"given":"Matteo","family":"Cal\u00ec","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-6075","authenticated-orcid":false,"given":"Alberto","family":"Aiolfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Bonitta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Manara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Biondi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Bona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Bonavina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"European Foregut Society (EFS) Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Borbely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moustafa","family":"Elshafei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Gisberz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gutschow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Ivo","family":"van Berge Henegouwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheraz","family":"Markar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calin","family":"Popa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Schlanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schoppmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Simi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ognjan","family":"Skrobic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Theodorou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"2464_CR1","doi-asserted-by":"publisher","first-page":"55","DOI":"10.14740\/WJON1254","volume":"11","author":"EO Then","year":"2020","unstructured":"Then EO, Lopez M, Saleem S, Gayam V, Sunkara T, Culliford A, Gaduputi V (2020) Esophageal cancer: an updated surveillance epidemiology and end results database analysis. 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