title: Intrathoracic esophagojejunostomy using OrVil™ for gastric adenocarcinoma involving the esophagus.
abstract: OBJECTIVE
  To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrVil™.
  
  
  METHODS
  After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrVil™was inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009, we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus.
  
  
  RESULTS
  The median operation time was 314 min (range; 210-367 min), and median blood loss was 210 mL (range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3 (range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. The median hospital stay was 16 d (range: 15-20 d). The median length of esophageal involvement was 14 mm (range: 6-48 mm) and that of the resected esophagus was 40 mm (range: 35-55 mm); all resected specimens had tumor-free margins.
  
  
  CONCLUSIONS
  This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yajima
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Kosugi
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kano
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ichikawa
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hanyu
authors.affiliation: Kazuhito Yajima, Tatsuo Kanda, Shin-ichi Kosugi, Yosuke Kano, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Toshifumi Wakai, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
keywords: Esophageal invasion; Gastric cancer; Intrathoracic anastomosis; Lower mediastinal lymphadenectomy; OrVil™