PGI9 Using a New Powered Stapling System with Gripping Surface Technology Is Associated with Better Intraoperative Outcomes Among Patients with Gastric Carcinoma

Bleeding is one of the major complications related to the anastomosis after gastrectomy. During gastrectomy, stapling thick gastric tissue can be challenging and might lead to intraoperative bleeding. Thus, a newer powered stapling system was introduced to account for tissue movements and might associated with fewer intraoperative intervention. Thus, we aim to evaluate the bleeding complications and its immediate management such as endoscopic intervention with the use of the new stapling system. A retrospective analysis was conducted using the electronic medical records of Department of General Surgery at the Fourth Hospital of Hebei Medical University in China. Patients with gastric malignant tumor who underwent radical gastrectomy for the first time from March 2018 to September 2020 were identified and were divided to the new powered stapling system with Gripping Surface Technology (GST) group and non-GST group by the stapler used during the operation. Outcomes were intraoperative complications and surgical interventions. Multivariate analyses were conducted to compare the measured outcomes between the two groups. 121 patients were included for the data analyses (59 patients in the GST group and 62 patients in the non-GST group). The baseline characteristics in the two groups were highly comparable. Multiple regression analyses showed that the use of GST was associated with lower total intraoperative bleeding (coefficient -2.4618, p<0.0001) and total intraoperative intervention (coefficient -2.5797, p=0.0003). In addition, GST group was associated with fewer number of cartridges used (coefficient -0.2761, p=0.05). Multiple regression analysis didn’t identify significant difference for the comparison of operation time. Use of the GST stapling system is associated with lower intraoperative bleeding and reduces the need for staple line interventions, suggesting that the use of the GST stapling system can create a more secure staple line and might lead to a more desirable procedural outcome.