Smaller Circular Staplers Do Not Compromise Postoperative Quality of Life in Esophagojejunostomy: A Ct-Based Clinical Trial Publisher Pubmed



Yazdi SAM ; Chinisaz F ; Mousavi A ; Asefi H ; Sahebi L
Source: Annals of Surgical Oncology Published:2026

Abstract

Background: The optimal size of circular staplers for esophagojejunostomy remains a subject of debate, with concerns that smaller staplers may increase the risk of postoperative complications and impair quality of life (QoL). The purpose of this study was to evaluate the impact of circular stapler size and anastomotic lumen diameter, measured via postoperative computed tomography (CT) imaging, on patient-reported quality of life following esophagojejunostomy. Patients and Methods: This prospective observational cohort study included patients who underwent esophagojejunostomy using circular staplers. Anastomotic lumen diameter was measured using postoperative CT imaging. Quality of life was assessed at a 6-month follow-up using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-STO22 and Eastern Cooperative Oncology Group (ECOG) performance status scales. Outcomes were compared across stapler sizes and corresponding lumen diameters. Results: No statistically significant differences in EORTC QLQ-STO22 or ECOG scores were observed between stapler size groups. Additionally, anastomotic lumen diameter showed no correlation with quality-of-life outcomes. Conclusions: Smaller circular staplers, often used due to intraoperative anatomical limitations, do not adversely affect postoperative quality of life. These findings suggest that insisting on larger stapler sizes may be unnecessary and that smaller staplers can be used safely when indicated. © Society of Surgical Oncology 2026.