637 ANALYSIS OF THE OUTCOMES OF HAND-SEWN COMPARED TO THE STAPLED ANASTOMOSIS AFTER TOTAL GASTRECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Abstract The complications related to esophagojejunal anastomosis are among the leading issues in the postoperative period of total gastrectomy. This review aims to evaluate the surgical outcomes of hand-sewn esophageal anastomosis compared to mechanical anastomosis for the reconstruction of total gastrectomy. Methods A systematic review and meta-analysis of comparative studies evaluating hand-sewn and stapled anastomosis was performed. Results A total of 12 studies were selected, comprising 1761 individuals. The operation time was higher in the hand-sewn anastomosis group (mean difference [MD] = 22.13 minutes; 95%CI: 3.97, 40.29). However, the risk for anastomotic fistula was not different between the groups (difference risk [DR] = 0.00; 95%CI: −0.03, 0.03). Also, the rate of intracavitary abscess (DR = -0.02; 95%CI: −0.07, 0.02); the reoperation rate (DR = -0.00; 95%CI: −0.01, 0.01); postoperative complications (DR = 0.12; 95%CI: −0.01, 0.25); postoperative mortality (DR = 0.02; 95%CI: −0.02, 0.06); anastomotic stenosis (DR = -0.01; 95%CI: −0.03, 0.00); and length of hospital stay (mean difference [MD] = 3.52 days; 95%CI: −0.49, 7.53) were no different between groups. Conclusion The results indicate that the hand-sewn and stapled esophageal anastomosis have similar surgical outcomes. Stapled anastomosis has a shorter operation time being.