Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy.
OBJECTIVE
Totally laparoscopic total gastrectomy (TLTG) is unpopular because reconstruction is difficult. In fact, esophagojejunostomy is the most difficult surgical technique in TLTG. We adopted functional end-to-end anastomosis for esophagojejunostomy to simplify the procedure. The present study assesses the feasibility and surgical outcomes of TLTG with functional end-to-end esophagojejunostomy.


METHODS
We assessed the intraoperative and postoperative outcomes of 65 consecutive patients who underwent TLTG with functional end-to-end esophagojejunostomy at Tonan Hospital between January 2006 and August 2011.


RESULTS
The mean surgical duration was 271.5 ± 64.7 min, and the mean blood loss was 85.2 ± 143.2 g. One patient (1.5 %) was converted to open surgery, and two patients (3.1 %) required reoperation due to ileus because of an internal hernia and jejunojejunostomy leakage. No reoperation was associated with functional end-to-end esophagojejunostomy. The mean hospital stay was 21.4 ± 13.5 days. Ten patients (15.4 %) developed postoperative complications, of which three (4.6 %) were anastomotic stenosis associated with functional end-to-end esophagojejunostomy. All of these were resolved by endoscopic dilation.


CONCLUSIONS
Functional end-to-end esophagojejunostomy in TLTG is safe and feasible.
Department of Surgery, Tonan Hospital, N1W6, Chuuou-ku, Sapporo, Hokkaido 060-0001, Japan. yuma-ebi@wc4.so-net.ne.jp
Yuma
Y
Ebihara
Shunichi
S
Okushiba
Yo
Y
Kawarada
Shuji
S
Kitashiro
Hiroyuki
H
Katoh
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D015331:Cohort Studies; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D061214:Patient Safety; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome