[Total gastrectomy using Longmire's and Roux method. Evaluation of the invagination technique for esophageal-jejunal...

582 patients were gastrectomized between 1976 and 1996 in the Department for Gastrointestinal Surgery in Katowice/Poland for gastric cancer. Before 1985 esophago-jejunal anastomosis have been accomplished using a simple end-to-end or special end-to-side (Schreiber-Eichfuss) method with jejunoplication. Thereafter we used an end-to-end invagination method with 4-5 cm deep intussusception of the first raw of sutures into jejunum. Comparison of the occurrence of short and long term complications at the site of esophago-jejunal anastomosis showed that invagination technique is safer that the previous one. It is associated with the lower rate of short and long term complications (dehiscence, stenosis, oesophagitis). Details of the surgical procedure facilitating the accomplishment of the tight and safe anastomosis are presented.