A modified method of laparoscopic side-to-side esophagojejunal anastomosis: report of 14 cases.
BACKGROUND
Alimentary tract reconstruction after laparoscopic total gastrectomy is a technical challenge. Although feasible, reconstruction through a small incision has several drawbacks. The authors therefore report a modified method of laparoscopic side-to-side esophagojejunal anastomosis developed at their hospital.


METHODS
The side to side esophagojejunal anastomosis was completed with a endo-GIA firing, followed by transection of the jejunum and esophagus with another firing of endo-GIA.


RESULTS
This modified procedure was performed successfully for 14 patients with gastric cancer. The mean operation time for this procedure was 42.5 +/- 10.2 min. No postoperative death, fistula, or hemorrhage occurred. All the patients were followed up for a mean period of 14.5 months with no cancer recurrence at the anastomosis or anastomotic stricture. All the patients had a barium swallow test 6-2 months after the operation. The mean maximum diameter of the anastomosis was 3.8 cm (range, 3.0-4.2 cm). Four patients experienced temporary symptoms of dumping syndrome or dysphagia, which disappeared 6 months postoperatively.


CONCLUSIONS
The authors consider this modified laparoscopic side-to-side esophagojejunal anastomosis to be safe, less challenging, and more economical, providing an alternative for alimentary tract reconstruction after laparoscopic total gastrectomy.
Ziqiang
Wang
W
General Surgery Department, South-West Hospital, ChongQing 400038, China. wangzq1@vip.sina.com
ZhiMin
Cai
C
Jun
Chen
C
Xiao
Lei
L
Huaxing
Luo
L
PeiWu
Yu
Y
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery