Assessment of the Double-Staple Technique for Esophagoenteric Anastomosis in Gastric Cancer

Audrey H. Choi, Amanda Arrington, Ann Falor, Rebecca A. Nelson, Michael Lew, Joseph Chao, Byrne Lee, Joseph Kim

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Introduction: Reports on outcomes after double-staple technique (DST) for total and proximal gastrectomy are limited, originating mostly from Asian centers. Our objective was to examine anastomotic leak and stricture with DST for esophagoenteric anastomosis in gastric cancer patients. Methods: A single institution review was performed for patients who underwent total/proximal gastrectomy with DST between 2006 and 2015. DST was performed using transoral anvil delivery (OrVil™) with end-to-end anastomosis. Clinical characteristics and outcomes, including anastomotic leak and stricture, were recorded. Results: Overall, DST was performed in 60 patients [total gastrectomy (81.7 %, n = 49/60), proximal gastrectomy (10.0 %, n = 6/60), and completion gastrectomy (8.3 %, n = 5/60)]. Neoadjuvant chemotherapy was administered to 21 patients (35.0 %), and 6 patients (10.0 %) received external beam radiation therapy prior to completion gastrectomy. Operative approach was open (51.7 %, n = 31/60), laparoscopic (43.3 %, n = 26/60), or robotic (5.0 %, n = 3/60). Anastomotic leak occurred in 6.7 % (n = 4/60), while stricture independent of leak was identified in 19.0 % (n = 11/58) of patients. Complications occurred in 38.3 % (n = 23/60) of patients, of which 52 % were classified as Clavien-Dindo grades III–V complications. Conclusion: In the largest Western series of DST for esophagoenteric anastomoses in gastric cancer surgery, our experience demonstrates that DST is safe and effective with low rates of leak and stricture.

Original languageEnglish
Pages (from-to)688-692
Number of pages5
JournalJournal of Gastrointestinal Surgery
Issue number4
StatePublished - Apr 1 2016

Bibliographical note

Funding Information:
Dr. Chao’s efforts were supported by the National Cancer Institute of the National Institutes of Health under award number NIH 5K12CA001727-20. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. There was no additional funding provided by any source.

Publisher Copyright:
© 2016, The Society for Surgery of the Alimentary Tract.


  • Double-staple technique
  • Gastric cancer
  • Proximal gastrectomy
  • Total gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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