J Parker1, H Sell, K Stahlfeld. 1. Department of Surgery, Mercy Hospital of Pittsburgh, 1400 Locust St., Pittsburgh, PA 15219, USA.
Abstract
BACKGROUND: The critical part of any operation involving a proximal gastric resection is the esophageal anastomosis. Leakage from this anastomosis is one of the main reasons for postoperative morbidity and death after gastrectomy. Application of the double-stapling technique affords many of the same advantages that it does for low rectal tumors, especially in obese patients with narrow costal margins. METHODS: A new technique for esophagojejunostomy after total gastrectomy for gastric cancer is described. RESULTS: This technique has been used in 3 patients. At a follow-up of 22 months, there have been no anastomotic leaks or evidence of clinical stenoses. CONCLUSIONS: This technique minimizes manipulation and dissection around the distal esophagus. Not only does this make the operation easier, but it also allows for a longer proximal resection margin. Possibly this will result in lower rates of esophageal breakdown.
BACKGROUND: The critical part of any operation involving a proximal gastric resection is the esophageal anastomosis. Leakage from this anastomosis is one of the main reasons for postoperative morbidity and death after gastrectomy. Application of the double-stapling technique affords many of the same advantages that it does for low rectal tumors, especially in obesepatients with narrow costal margins. METHODS: A new technique for esophagojejunostomy after total gastrectomy for gastric cancer is described. RESULTS: This technique has been used in 3 patients. At a follow-up of 22 months, there have been no anastomotic leaks or evidence of clinical stenoses. CONCLUSIONS: This technique minimizes manipulation and dissection around the distal esophagus. Not only does this make the operation easier, but it also allows for a longer proximal resection margin. Possibly this will result in lower rates of esophageal breakdown.
Authors: Bruno Zilberstein; Carlos Eduardo Jacob; Leandro Cardoso Barchi; Osmar Kenji Yagi; Ulysses Ribeiro; Brian Guilherme Monteiro Marta Coimbra; Ivan Cecconello Journal: Arq Bras Cir Dig Date: 2014 Apr-Jun