Esophagojejunostomy: Mechanically stapled versus hand-sutured anastomoses

Mechanically stapled and hand-sewn esophagojejunostomy anastomoses allow the same high standard of performance: there is no difference in mortality, anastomotic leaks and other complications. The high costs of the stapler are therefore not defrayed by reduced morbidity, hospitalization time or mortality. Manually placed sutures remain crucial to reinforce any stapled anastomotic leaks; on the other hand, not in all cases manual suturing can be performed. Both methods must therefore not be neglected during surgical training and practice.