Impact of Circular Stapler Size on Short‐Term Outcomes and Long‐Term Quality of Life After McKeown Esophagectomy

Background The circular stapling technique (CST) is reported to be a simple and time‐efficient method; however, it is associated with a high incidence of anastomotic stenosis for McKeown esophagectomy. Meanwhile, the impact of circular stapler size remains controversial. We aimed to investigate the impact of circular stapler size on both short‐term outcomes and long‐term quality of life (QOL) after McKeown esophagectomy. Methods In total, 63 consecutive patients who underwent McKeown esophagectomy for esophageal cancer between 2019 and 2022 were eligible. We examined the association between circular stapler size and short‐term outcomes and long‐term QOL using the PGSAS‐37. Results 35 (55.6%) patients underwent anastomosis with a 21 mm stapler, whereas 28 (44.4%) patients used a 23 mm stapler. No significant differences were observed between the groups. The incidence of anastomotic leakage did not differ significantly between the groups (5.7% vs. 7.1%, p = 1.00) Also, the incidence of anastomotic stenosis did not differ between the groups (25.7% vs. 21.4%, p = 0.77). However, in QOL assessment, the meal‐related subscale (SS) score in the 21 mm group was significantly worse than in the 23 mm group ( p = 0.02). Regarding the details the meal‐related SS score, the feeling of dysphagia was significantly worse in the 21 mm group ( p < 0.01). Conclusions Short‐term outcomes did not differ between patients who underwent anastomosis with a 21 mm stapler and those with a 23 mm stapler, however QOL, particularly the feeling of dysphagia, was worse in patients who used a 21 mm stapler compared to those who used a 23 mm stapler.