Retrospective Study
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World J Gastroenterol. Oct 7, 2014; 20(37): 13556-13562
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13556
Novel method for esophagojejunal anastomosis after laparoscopic total gastrectomy: Semi-end-to-end anastomosis
Yong-Liang Zhao, Chong-Yu Su, Teng-Fei Li, Feng Qian, Hua-Xing Luo, Pei-Wu Yu
Yong-Liang Zhao, Chong-Yu Su, Teng-Fei Li, Feng Qian, Hua-Xing Luo, Pei-Wu Yu, Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Author contributions: Zhao YL and Yu PW designed the research; Zhao YL, Su CY, Li TF, Qian F and Luo HX performed the research and analyzed the data; Zhao YL wrote the paper.
Supported by National Natural Science Foundation of China, No. 81071980
Correspondence to: Pei-Wu Yu, MD, Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, China. yupeiwu01@vip.sina.com
Telephone: +86-23-68754161 Fax: +86-23-68754167
Received: April 9, 2014
Revised: June 11, 2014
Accepted: June 25, 2014
Published online: October 7, 2014
Processing time: 180 Days and 20.6 Hours
Abstract

AIM: To test a new safe and simple technique for circular-stapled esophagojejunostomy in laparoscopic total gastrectomy (LATG).

METHODS: We selected 26 patients with gastric cancer who underwent LATG and Roux-en-Y gastrointestinal reconstruction with semi-end-to-end esophagojejunal anastomosis.

RESULTS: LATG with semi-end-to-end esophagojejunal anastomosis was successfully performed in all 26 patients. The average operation time was 257 ± 36 min, with an average anastomosis time of 51 ± 17 min and an average intraoperative blood loss of 88 ± 46 mL. The average postoperative hospital stay was 8 ± 3 d. There were no complications and no mortality in this series.

CONCLUSION: The application of semi-end-to-end esophagojejunal anastomosis after LATG is a safe and feasible procedure, which can be easily performed and has a short operation time in terms of anastomosis.

Keywords: Laparoscopic total gastrectomy; Gastrointestinal reconstruction; Semi-end-to-end esophagojejunal anastomosis; Roux-en-Y anastomosis; Gastric cancer

Core tip: Digestive tract reconstruction after laparoscopic total gastrectomy is always a challenge for surgeons. Traditional Roux-en-Y anastomosis is difficult through the small incision in laparoscopic gastrectomy and severe complications, such as anastomotic stenosis, often occur when the operation is performed improperly. The method of semi-end-to-end esophagojejunal anastomosis that we developed is easy to operate and can also prevent anastomotic stenosis and other complications effectively.