Comparison of the outcomes between total eversion and conventional triangulating stapling technique in cervical esophagogastric anastomosis after esophagectomy: a propensity score-matched analysis



Anastomotic leakage and stenosis remain major problems after esophageal reconstruction. This study evaluated the clinical outcomes between the total eversion (TE) triangulating stapling technique (TST) and conventional (C) TST.


The study included 404 consecutive patients with esophageal cancer who underwent cervical esophagogastrostomy by TST between January 2013 and December 2018. The postoperative outcomes were compared between TE-TST and C-TST using propensity score-matched analysis.


Before matching, the cT stage and the cTNM stage were different between the groups. After matching, each group consisted of 128 patients. The patients’ background characteristics were similar between the groups. Although the incidence of anastomotic leakage was similar between the groups (p = 0.216), anastomotic stricture occurred in 19 (14.8%) and 7 (5.5%) patients in the C-TST and the TE-TST groups, respectively (p = 0.021).


The incidence of anastomotic stenosis was significantly lower in the TE-TST group than in the C-TST group. TE-TST decreases the incidence of anastomotic stricture and can improve the quality of life in patients undergoing esophagectomy.

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Correspondence to Masayuki Watanabe.

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This study was approved by the Cancer Institute Hospital Clinical Research Review Board. The need for informed consent was waived because of the retrospective design of the study.

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Takahashi, K., Watanabe, M., Ushida, Y. et al. Comparison of the outcomes between total eversion and conventional triangulating stapling technique in cervical esophagogastric anastomosis after esophagectomy: a propensity score-matched analysis. Esophagus (2021).

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  • Esophagectomy
  • Triangulating stapling technique
  • Anastomotic stenosis