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A new technique for esophagojejunostomy after total gastrectomy for gastric cancer
J Parker1, H Sell, K Stahlfeld
1Department of Surgery, Mercy Hospital of Pittsburgh, 1400 Locust St., Pittsburgh, PA 15219, USA.
Background:
The critical part of any operation involving a proximal gastric resection is the esophageal anastomosis. Leakage from this anastomosis is one of the main reasons for postoperative morbidity and death after gastrectomy. Application of the double-stapling technique affords many of the same advantages that it does for low rectal tumors, especially in obese patients with narrow costal margins.
Methods:
A new technique for esophagojejunostomy after total gastrectomy for gastric cancer is described.
Results:
This technique has been used in 3 patients. At a follow-up of 22 months, there have been no anastomotic leaks or evidence of clinical stenoses.
Conclusions:
This technique minimizes manipulation and dissection around the distal esophagus. Not only does this make the operation easier, but it also allows for a longer proximal resection margin. Possibly this will result in lower rates of esophageal breakdown.