Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study

World J Gastroenterol. 2015 Mar 14;21(10):2973-81. doi: 10.3748/wjg.v21.i10.2973.

Abstract

Aim: To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy (LTG).

Methods: Between July 2010 and December 2012, 58 consecutive patients with early gastric cancer underwent LTG were enrolled. We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients. Then patients' characteristics, perioperative outcome and histopathologic data were analyzed retrospectively.

Results: The mean age and body mass index were 59.3 ± 9.7 years and 22.7 ± 2.6 kg/m(2). The mean operation, reconstruction and anvil insertion times (from gastric incision to linear stapling) were 251.8 ± 57.0, 43.1 ± 2.8 and 4.2 ± 1.9 min, respectively. Intraoperative blood loss was 204.6 ± 156.3 mL and there was no open conversion. The postoperative complications were in 8 cases (delayed gastric emptying in 4 cases, pulmonary complication in 2 cases, pancreatitis in 1 case, anastomotic stricture in 1 case). Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention. The patients were discharged at a mean of 9.6 ± 2.0 d after surgery. Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively. The mean proximal margin of specimen was 2.7 ± 2.8 cm

Conclusion: Roux-en Y esophagojejunostomy using the double stapling technique is simple and rapid, and it may offer a solid, alternative reconstruction method for LTG or proximal gastrectomy.

Keywords: Gastrectomy; Jejunostomy; Laparoscopic surgery; Roux-en-Y anastomoses; Surgical stapling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anastomosis, Roux-en-Y
  • Esophagostomy / adverse effects
  • Esophagostomy / methods*
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Humans
  • Jejunostomy / adverse effects
  • Jejunostomy / methods*
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Suture Techniques* / adverse effects
  • Treatment Outcome