[Reconstructive method of the alimentary tract after total gastrectomy]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Surgical Innovation

Context:

• Total gastrectomy is a critical procedure for gastric carcinoma.
• Reconstruction of the alimentary tract post-gastrectomy presents surgical challenges.
• Evaluating different anastomotic techniques is essential for patient outcomes.

Purpose:

• To compare the safety and efficacy of four distinct alimentary tract reconstruction methods after total gastrectomy for gastric cancer.
• To identify the optimal technique minimizing complications such as anastomotic leakage and operative mortality.

Summary:

• This study analyzed 92 cases of total gastrectomy for gastric carcinoma, comparing end-to-side/end-to-end esophagojejunostomy (48 cases), rho-shaped esophagojejunostomy (28 cases), and end-to-end esophagoduodenostomy (16 cases).
• Overall anastomotic leakage occurred in 4.3% and operative mortality in 2.2%.
• The rho-shaped esophagojejunostomy group reported zero anastomotic leakage, highlighting its safety and efficacy. End-to-end esophagoduodenostomy, while simple, has limitations due to potential anastomotic tension.

Impact:

• Findings suggest rho-shaped esophagojejunostomy as a highly safe and effective method for post-gastrectomy reconstruction.
• Identifies specific indications and limitations for end-to-end esophagoduodenostomy, aiding surgical decision-making.
• Contributes to improving patient outcomes and reducing morbidity in gastric cancer surgery.