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Updated: Mar 3, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Technical and Survival Risks Associated With Esophagojejunostomy by Laparoscopic Total Gastrectomy for Gastric
Manabu Yamamoto1, Hiroyuki Kawano, Shohei Yamaguchi
1*Department of Gastroenterological Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka †Department of Gastroenterological Surgery, National Kyushu Medical Center, Chuo-ku, Japan.
Background:
We performed esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG) using functional end-to-end anastomosis (FEEA) as the first choice and laparoscopic-assisted total gastrectomy (LATG) using a circular stapler with a transorally inserted anvil as the second choice.
Patients And Methods:
We examined 109 patients with gastric cancer who underwent TLTG and LATG. Among these, 100 patients underwent TLTG and the rest underwent LATG.
Results:
The length of resected esophageal segment in LATG patients was significantly longer than that in TLTG patients (P<0.001). The length of the resected esophagus segment was inversely correlated with body mass index in cases of esophagojejunostomy by FEEA (P<0.05). Multivariate analysis revealed that T factor, N factor, and severe complications were the independent factors for survival.
Conclusions:
Esophagojejunostomy using FEEA or a circular stapler with a transorally inserted anvil should be selected according to the length of the resected esophageal segment and/or body mass index.
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