title: Stenosis of esophago-jejuno anastomosis after gastric surgery.
abstract: BACKGROUND
  Stenosis of esophago-jejuno anastomosis is one of the postoperative complications of gastric surgery. This complication usually manifests with the symptom of dysphagia and is treated by endoscopic dilatation. No large-scale studies have been conducted to determine the incidence of this complication after surgery.
  
  
  METHODS
  The data of a total of 1478 consecutive patients who underwent total, proximal, or completion gastrectomy, including esophago-jejuno anastomosis, between 2000 and 2008 were analyzed retrospectively with a view to determining the incidence of anastomotic stenosis.
  
  
  RESULTS
  Sixty patients (4.1%) developed stenosis of the esophago-jejuno anastomosis which needed to be treated by endoscopic balloon dilatation. The average interval between the surgery and detection of stenosis was 67.4 days (median = 58.0). Multivariate analysis identified female gender, proximal gastrectomy, use of a narrow-sized stapler, and the choice of the stapling device as significant factors influencing the risk of development of anastomotic stenosis.
  
  
  CONCLUSIONS
  Esophago-jejuno anastomotic stenosis appears to be a common late postoperative complication after gastric surgery. Endoscopic examination and treatment yielded favorable outcomes in patients complaining of dysphagia after gastric surgery.
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, Japan. tfukagaw@ncc.go.jp
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukagawa
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.forename: Ichiro
authors.initials: I
authors.lastname: Oda
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Deguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Saka
authors.forename: Shinji
authors.initials: S
authors.lastname: Morita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Katai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002404:Catheterization; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000628:therapy; D004935:Esophageal Diseases / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D005743:Gastrectomy; D006801:Humans; D015994:Incidence; D007579:Jejunal Diseases / Q000453:epidemiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling; D016896:Treatment Outcome
references.citation: Hepatogastroenterology. 1997 Sep-Oct;44(17):1509-12
references.pmid: 9356881
references.citation: Gastric Cancer. 2000 Sep 29;3(2):97-101
references.pmid: 11984718
references.citation: J Surg Oncol. 1997 Oct;66(2):127-9
references.pmid: 9354169
references.citation: Br J Surg. 2003 Jul;90(7):850-3
references.pmid: 12854112
references.citation: Eur J Surg Oncol. 2000 Mar;26(2):168-71
references.pmid: 10744938
references.citation: Yonsei Med J. 1993 Dec;34(4):334-9
references.pmid: 8128738
references.citation: Int Surg. 1988 Jan-Mar;73(1):23-8
references.pmid: 3360573
references.citation: Endoscopy. 2009 May;41(5):421-6
references.pmid: 19418396
references.citation: Surgery. 1986 May;99(5):598-603
references.pmid: 3704916
references.citation: Dig Surg. 2007;24(3):169-72
references.pmid: 17476107
references.citation: Am J Surg. 1991 Sep;162(3):256-9
references.pmid: 1928587
references.citation: J Thorac Cardiovasc Surg. 1996 Jun;111(6):1141-6; discussion 1147-8
references.pmid: 8642814
references.citation: Gastrointest Endosc. 2009 May;69(6):1029-33
references.pmid: 19215919
references.citation: Hepatogastroenterology. 2000 Jul-Aug;47(34):1026-9
references.pmid: 11020870
references.citation: Arch Surg. 1988 Jun;123(6):759-62
references.pmid: 3285813
references.citation: Ann Surg. 1989 Jan;209(1):99-104
references.pmid: 2910218
references.citation: Surg Gynecol Obstet. 1990 May;170(5):445-7
references.pmid: 2326725