title: Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study.
abstract: To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy (LTG).
  
  
  
  Between July 2010 and December 2012, 58 consecutive patients with early gastric cancer underwent LTG were enrolled. We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients. Then patients' characteristics, perioperative outcome and histopathologic data were analyzed retrospectively.
  
  
  
  The mean age and body mass index were 59.3 ± 9.7 years and 22.7 ± 2.6 kg/m(2). The mean operation, reconstruction and anvil insertion times (from gastric incision to linear stapling) were 251.8 ± 57.0, 43.1 ± 2.8 and 4.2 ± 1.9 min, respectively. Intraoperative blood loss was 204.6 ± 156.3 mL and there was no open conversion. The postoperative complications were in 8 cases (delayed gastric emptying in 4 cases, pulmonary complication in 2 cases, pancreatitis in 1 case, anastomotic stricture in 1 case). Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention. The patients were discharged at a mean of 9.6 ± 2.0 d after surgery. Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively. The mean proximal margin of specimen was 2.7 ± 2.8 cm
  
  
  
  Roux-en Y esophagojejunostomy using the double stapling technique is simple and rapid, and it may offer a solid, alternative reconstruction method for LTG or proximal gastrectomy.
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Jae Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Chang In
authors.initials: CI
authors.lastname: Choi
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Kim
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Dae Hwan
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Jeon
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Jae Hun Kim, Chang In Choi, Dong Il Kim, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea.
authors.forename: Do Youn
authors.initials: DY
authors.lastname: Park
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004946:Esophagostomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Gastrectomy; Jejunostomy; Laparoscopic surgery; Roux-en-Y anastomoses; Surgical stapling