Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2022; 14(11): 1285-1296
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1285
Disturbed passage of jejunal limb near esophageal hiatus after overlapped esophagojejunostomy following laparoscopic total gastrectomy
Hirokazu Noshiro, Keiichiro Okuyama, Yukie Yoda
Hirokazu Noshiro, Yukie Yoda, Department of Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan
Keiichiro Okuyama, Department of Surgery, Saga University, Saga 849-8501, Japan
Author contributions: Noshiro H contributed to conceptualization, methodology, formal analysis, investigation, writing-original draft, writing-review & editing; Okuyama K contributed to writing-review & editing; Yoda Y contributed to investigation; All authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Saga University Hospital (Approval No. 2020-05-R-02).
Informed consent statement: Informed written consent was obtained from the patient and her family for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hirokazu Noshiro, FACS, MD, PhD, Professor, Surgeon, Department of Surgery, Saga University Faculty of Medicine, Nabeshima 5-1-1, Saga 849-8501, Japan. noshiro@cc.saga-u.ac.jp
Received: July 25, 2022
Peer-review started: July 25, 2022
First decision: September 4, 2022
Revised: September 16, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 27, 2022
Research background

Overlapped esophagojejunostomy (OEJ) is a secure purely laparoscopic reconstruction after laparoscopic total gastrectomy (LTG). Very few cases of postoperative anastomotic leakage or stenosis have been reported in patients treated with OEJ after LTG.

Research motivation

We have experienced five unusual cases of jejunal limb stricture near the esophageal hiatus without anastomotic stenosis during long-term observation after LTG with OEJ.

Research objectives

The objectives in this paper are mechanisms and prevention for this complication are described.

Research methods

From April 2009 until May 2020, 211 patients who underwent LTG following by OEJ for reconstruction of the alimentary tract were enrolled in this study.

Research results

We describe the characteristics of this complication to assist treatment and prevention.

Research conclusions

We had experienced five cases, all patients needed reoperation. We needed to know the mechanism of this complication.

Research perspectives

LTG was widely used for gastric carcinoma. OEJ is a secure purely laparoscopic reconstruction method. Postoperative complications were very low. However, we had experienced unusual cases of jejunal limb stricture.