الفهرس 
Anatomy of the Esophagus and Esophagogastric JunctionOnly 14 pages are availabe for public view
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Abstract
Background: Esophagictomy is a major operation indicated for many reasons mainly in esophageal cancer and loss of esophageal function, this operation due to many considerations we can say it is a true challenge to the upper GI surgeon.
Aim of the work: The main purpose of the present study is to review the difference between hand-sewn and stapler osephagogastric anastomosis as regards post-operative leakage and stricture formation.
Patients and Methods: In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. In the present systematic review and meta-analysis, A 746 cases were included in hand sewn group and 691 cases in stapled anastomosis.
Results: In the present systematic review and meta-analysis, 9 studies including 1437 patients reported the leak incidence. There was a statistically insignificant heterogeneity in the studies. Using the random effects model, the outcome results revealed that hand sewn was significantly more than stapled anastomosis regarding leak incidence. In the present systematic review and meta-analysis, 9 studies including 1437 patients (746 in hand sewn and 691 stapled anastomosis)—reported the Stricture incidence. There was a statistically insignificant heterogeneity in the studies. There was a statistically significant heterogeneity in the studies. Using the random effects model, the outcome results revealed that hand sewn was significantly more than stapled anastomosis regarding post-operative complications incidence.
Conclusion: This meta-analysis, comparing stapled and hand sewn esophagogastric anastomoses, showed that stapled anastomosis decreased the rate of anastomotic leaks in circular and liner cutter staplers, decreased the rate of anastomotic stricture in the neck anastomotic subgroup, shortened the operating time, decrease the rate of post-operative complications but the cost of using staplers is high compared to the hand sewn technique.