Stenosis of esophago-jejuno anastomosis after gastric surgery.
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.
Fukagawa
Takeo
T
Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, Japan. tfukagaw@ncc.go.jp
Gotoda
Takuji
T
Oda
Ichiro
I
Deguchi
Yasunori
Y
Saka
Makoto
M
Morita
Shinji
S
Katai
Hitoshi
H
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
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