Esophagojejunostomy With Linear Staplers in Laparoscopic Total Gastrectomy: Experience With 168 Cases in 5 Consecutive Years

Surg Laparosc Endosc Percutan Tech. 2017 Oct;27(5):e101-e107. doi: 10.1097/SLE.0000000000000464.

Abstract

Purpose: We evaluate surgical outcomes of intracorporeal esophagojejunostomy in laparoscopic total gastrectomy using 2 linear stapler methods.

Materials and methods: The functional end-to-end anastomosis (FEEA) method was chosen as a first choice. The overlap method was chosen in cases with esophageal invasion. We retrospectively analyzed the early and late surgical outcomes of consecutive 168 laparoscopic total gastrectomy cases from April 2011 to December 2016.

Results and conclusions: The FEEA method was selected in 120 cases, and the overlap method was selected in 48 cases. The mean time of esophagojejunostomy for the FEEA and overlap method was 13.2 and 36.5 minutes, respectively. Two cases with FEEA method and 3 cases with overlap method experienced complications due to esophagojejunostomy leakage. These cases were treated without performing a reoperation. One case with FEEA method was complicated due to esophagojejunostomy stenosis. This case was endoscopically treated. Our procedures are safe and feasible.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Anastomotic Leak / etiology
  • Esophagostomy / instrumentation*
  • Esophagostomy / methods
  • Feasibility Studies
  • Female
  • Gastrectomy / instrumentation*
  • Gastrectomy / methods
  • Humans
  • Jejunostomy / instrumentation*
  • Jejunostomy / methods
  • Laparoscopy / instrumentation*
  • Laparoscopy / methods
  • Male
  • Operative Time
  • Stomach Neoplasms / surgery*
  • Surgical Staplers*
  • Surgical Stapling / instrumentation
  • Treatment Outcome