title: Minimum leakage rate (0.5%) of stapled esophagojejunostomy with sacrifice of a small part of the jejunum after total gastrectomy in 390 consecutive patients.
abstract: BACKGROUND
  The development of new surgical instruments and devices has facilitated the performance of esophagojejunostomy after total gastrectomy. However, total prevention of dehiscence of anastomoses remains difficult. We introduced a new procedure for esophagojejunostomy using a circular stapler, requiring sacrifice of only a small part of the jejunum.
  
  
  METHODS
  The study group comprised 390 consecutive patients who underwent reconstruction by Roux-en-Y esophagojejunostomy, performed with a circular stapler, sacrificing a small part of the jejunum after total gastrectomy. We assessed anastomotic leakage and anastomotic stenosis after surgery.
  
  
  RESULTS
  Only 2 patients (0.5%) had leakage and 4 (1.0%) had anastomotic stenosis after reconstruction. All the patients were cured by conservative therapy.
  
  
  CONCLUSIONS
  Esophagojejunostomy performed with a circular stapler after total gastrectomy, with sacrifice of only a small part of the jejunum, is a useful and easy procedure, with a leakage rate of 0.5%.
authors.affiliation: Department of Surgery, Jichi Medical University, Shimotsuke, Japan. mhyodo@jichi.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Hyodo
authors.forename: Y
authors.initials: Y
authors.lastname: Hosoya
authors.forename: Y
authors.initials: Y
authors.lastname: Hirashima
authors.forename: H
authors.initials: H
authors.lastname: Haruta
authors.forename: K
authors.initials: K
authors.lastname: Kurashina
authors.forename: S
authors.initials: S
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.forename: W
authors.initials: W
authors.lastname: Arai
authors.forename: T
authors.initials: T
authors.lastname: Zuiki
authors.forename: Y
authors.initials: Y
authors.lastname: Yasuda
authors.forename: H
authors.initials: H
authors.lastname: Nagai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D004946:Esophagostomy / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007582:Jejunostomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery; D017792:Surgical Stapling / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*