[Esophagojejunal anastomosis after total gastrectomy]

The Authors discuss the technical criteria of digestive reconstruction after total gastrectomy for gastric cancer. Usually they employ stapling devices which are easy and quick to use and give good technical results. Performing a Roux-en-Y with an end-to-side esophagojejunostomy a circular device is preferred and a linear cutter for a side-to-side jejunojejunal anastomosis is used. Alternatively the jejunojejunal anastomosis may be performed with a circular and a linear stapler. Between 1970 and 1989, out of 160 total gastrectomies for cancer, 2 dehiscences were recorded in 103 mechanical anastomosis and none out of 57 manual anastomosis (p: n.s.); stenosis was observed in 2 cases after mechanical esophagojejunostomy and in none after manual anastomosis.