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  • Title: Technical and Survival Risks Associated With Esophagojejunostomy by Laparoscopic Total Gastrectomy for Gastric Carcinoma.
    Author: Yamamoto M, Kawano H, Yamaguchi S, Egashira A, Minami K, Morita M, Sakaguchi Y, Toh Y.
    Journal: Surg Laparosc Endosc Percutan Tech; 2017 Jun; 27(3):197-202. PubMed ID: 28441167.
    Abstract:
    BACKGROUND: We performed esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG) using functional end-to-end anastomosis (FEEA) as the first choice and laparoscopic-assisted total gastrectomy (LATG) using a circular stapler with a transorally inserted anvil as the second choice. PATIENTS AND METHODS: We examined 109 patients with gastric cancer who underwent TLTG and LATG. Among these, 100 patients underwent TLTG and the rest underwent LATG. RESULTS: The length of resected esophageal segment in LATG patients was significantly longer than that in TLTG patients (P<0.001). The length of the resected esophagus segment was inversely correlated with body mass index in cases of esophagojejunostomy by FEEA (P<0.05). Multivariate analysis revealed that T factor, N factor, and severe complications were the independent factors for survival. CONCLUSIONS: Esophagojejunostomy using FEEA or a circular stapler with a transorally inserted anvil should be selected according to the length of the resected esophageal segment and/or body mass index.
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