Prospective randomized controlled trial comparing the use of 3.5-mm and 4.8-mm staples in gastric surgery
Kunisaki, C.; Makino, H.; Takagawa, R.; Yamamoto, N.; Nagano, Y.; Fujii, S.; Kosaka, T.; Ono, H.A.; Akiyama, H.; Shimada, H.
Hepato-Gastroenterology 55(86-87): 1943-1947
2008
ISSN/ISBN: 0172-6390 PMID: 19102428 Document Number: 617312
The purpose of this study was to evaluate and compare the use of 4.8-mm and 3.8-mm staples in gastric resection. A series of 60 patients underwent distal or proximal gastrectomy. A 4.8-mm GIA universal stapler was randomly assigned for use in 50% of the patients and a 3.5-mm GIA universal stapler was assigned for use in the remaining 50%. Bleeding was observed in 20 patients (12 in the 4.8-mm group and eight in the 3.5-mm group). In the 4.8-mm group, bleeding was less frequent in patients with a stomach wall thickness of 7.0-9.0mm. In the 3.5-mm group, bleeding was less frequent in patients with a stomach wall thickness of 5.0-7.0mm. Inappropriate staple formation was observed in patients with thick stomach walls in each group. The appropriate staple size for gastric surgery may depend on the thickness of the stomach wall.