title: A new technique for esophagojejunostomy after total gastrectomy for gastric cancer.
abstract: BACKGROUND
  The critical part of any operation involving a proximal gastric resection is the esophageal anastomosis. Leakage from this anastomosis is one of the main reasons for postoperative morbidity and death after gastrectomy. Application of the double-stapling technique affords many of the same advantages that it does for low rectal tumors, especially in obese patients with narrow costal margins.
  
  
  METHODS
  A new technique for esophagojejunostomy after total gastrectomy for gastric cancer is described.
  
  
  RESULTS
  This technique has been used in 3 patients. At a follow-up of 22 months, there have been no anastomotic leaks or evidence of clinical stenoses.
  
  
  CONCLUSIONS
  This technique minimizes manipulation and dissection around the distal esophagus. Not only does this make the operation easier, but it also allows for a longer proximal resection margin. Possibly this will result in lower rates of esophageal breakdown.
authors.affiliation: Department of Surgery, Mercy Hospital of Pittsburgh, 1400 Locust St., Pittsburgh, PA 15219, USA.
authors.forename: J
authors.initials: J
authors.lastname: Parker
authors.forename: H
authors.initials: H
authors.lastname: Sell
authors.forename: K
authors.initials: K
authors.lastname: Stahlfeld
mesh_terms: D004867:Equipment Design; D004946:Esophagostomy; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation / Q000379:methods*; D011182:Postoperative Care; D013274:Stomach Neoplasms / Q000601:surgery*; D013528:Surgical Staplers