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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 3/2013

Open Access 01-03-2013 | How-I-Do-It article

Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy

Authors: Yuma Ebihara, Shunichi Okushiba, Yo Kawarada, Shuji Kitashiro, Hiroyuki Katoh

Published in: Langenbeck's Archives of Surgery | Issue 3/2013

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Abstract

Purpose

Totally laparoscopic total gastrectomy (TLTG) is unpopular because reconstruction is difficult. In fact, esophagojejunostomy is the most difficult surgical technique in TLTG. We adopted functional end-to-end anastomosis for esophagojejunostomy to simplify the procedure. The present study assesses the feasibility and surgical outcomes of TLTG with functional end-to-end esophagojejunostomy.

Methods

We assessed the intraoperative and postoperative outcomes of 65 consecutive patients who underwent TLTG with functional end-to-end esophagojejunostomy at Tonan Hospital between January 2006 and August 2011.

Results

The mean surgical duration was 271.5 ± 64.7 min, and the mean blood loss was 85.2 ± 143.2 g. One patient (1.5 %) was converted to open surgery, and two patients (3.1 %) required reoperation due to ileus because of an internal hernia and jejunojejunostomy leakage. No reoperation was associated with functional end-to-end esophagojejunostomy. The mean hospital stay was 21.4 ± 13.5 days. Ten patients (15.4 %) developed postoperative complications, of which three (4.6 %) were anastomotic stenosis associated with functional end-to-end esophagojejunostomy. All of these were resolved by endoscopic dilation.

Conclusion

Functional end-to-end esophagojejunostomy in TLTG is safe and feasible.
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Metadata
Title
Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy
Authors
Yuma Ebihara
Shunichi Okushiba
Yo Kawarada
Shuji Kitashiro
Hiroyuki Katoh
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 3/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1051-z

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