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Semi‐end‐to‐end esophagojejunostomy after laparoscopy‐assisted total gastrectomy better reduces stricture and leakage than the conventional end‐to‐side procedure: A retrospective study
Author(s) -
Duan Wei,
Liu Kaijun,
Fu Xiaolong,
Shen Xuqi,
Chen Jun,
Su Chongyu,
Yu Peiwu,
Zhao Yongliang
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24637
Subject(s) - medicine , gastrectomy , incidence (geometry) , surgery , laparoscopy , anastomosis , retrospective cohort study , cancer , physics , optics
Background and Objective Laparoscopy‐assisted total gastrectomy (LATG) has not gained popularity due to the technical difficulty of esophagojejunostomy (EJ) and the high incidence of EJ‐related complications. Herein, we compared two types of EJ for Roux‐en‐Y reconstruction to determine whether semi‐end‐to‐end (SETE) EJ is more convenient than the end‐to‐side (ETS) procedure and is capable of reducing stricture and leakage. Methods A total of 268 patients who underwent LATG with Roux‐en‐Y reconstruction were included in this study. Two types of EJ were applied for LATG: conventional ETS EJ and SETE EJ. The surgical outcomes and postoperative complications were compared. Results The mean reconstruction time in the SETE group was shorter than that in the ETS group (41.6 ± 8.0 min vs 51.3 ± 9.2 min, P = 0.000). The incidences of total EJ‐related complications, EJ leakage, and EJ stricture in the SETE group and ETS group were 1.1% (1/92) and 10.2% (18/176), 1.1% (1/92) and 4.0% (7/176), and 0 and 6.2% (11/176), respectively. The incidence of total EJ‐related complications in the SETE group was lower than that of the ETS group ( P = 0.006), and the incidence of EJ stricture in the SETE group was lower than that of the ETS group ( P = 0.034). Conclusions SETE EJ is more convenient than the conventional ETS procedure and is associated with a shorter reconstruction time and a lower incidence of EJ stricture and leakage.