Improved anastomotic technique for esophagojejunal anastomosis using circular stapler

Hiki, Naoki; Hosoda, Kei; Sakuraya, Mikiko; Washio, Marie; Chuman, Motohiro; Yamashita, Keishi

doi:10.1007/s00423-021-02417-0

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…The median length of the resected esophagus during lower-esophagogastrectomy was 40 mm. In terms of postoperative complications, three (15%) patients developed grade II intra-abdominal uid correction according to the Clavien-Dindo classi cation [11]. However, none of the patients presented with grade III or higher complications or anastomotic leakage.…”

Section: Resultsmentioning

confidence: 96%

Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer

Higuchi,

Niihara,

Minoura

et al. 2024

Preprint

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Background The appropriate extent of resection for esophagogastric junction cancer and the method of surgical approach remain controversial. This study aimed to assess the safety and outcomes of the parachute technique, which is an open transhiatal reconstruction method that facilitates stable reconstruction. Materials and methods The surgical outcomes of 20 consecutive patients who underwent open lower- esophagogastrectomy for EGJ cancer at Kitasato University Hospital from June 2019 to July 2023 were retrospectively reviewed. Surgical procedure (parachute technique): The esophagus was transected, and a purse-string suture was placed at the stump. Then, a fixing string was placed. Hence, the mucosa, muscular layer, and adventitia, including the string of the purse-string suture, were not displaced. By placing approximately 10 stay sutures around the whole esophageal stump, the esophageal stump can be opened to the maximum diameter. Then, insert the anvil head into the esophagus lumen while laying it sideways, and it can be put on smoothly without stress. Results In total, there were 17 and 3, male and female patients, respectively. The median esophageal invasion length was 12.5 (0–30) mm. One patient presented with cStage I EGJ cancer, four with cStage II, 14 with cStage III, and one with cStage IV. In terms of postoperative complications, three (15%) patients developed grade II intra-abdominal fluid correction according to the Clavien–Dindo classification. However, none of the patients presented with anastomotic leakage. Conclusions The parachute technique can be a safe and effective reconstruction technique as it does not cause anastomotic leakage.

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Section: Resultsmentioning

confidence: 96%

Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer

Higuchi,

Niihara,

Minoura

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…As mature surgical procedures, radical total gastrectomy and Roux-en-Y esophagojejunostomy are widely used in clinical practice ( 19 ). With the continuous optimization of the surgical technique and the improvement of the anastomosis method, the overall complication rate continues to gradually decrease.…”

Section: Discussionmentioning

confidence: 99%

Application value of continuous seromuscular layer sutures in the reinforcement of esophagojejunostomy in total gastrectomy for gastric cancer: a retrospective comparative cohort study

Fan¹,

Wang²,

Ding³

et al. 2022

J Gastrointest Oncol

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Background: The development process of gastrointestinal anastomosis is from complex to simple, from two layers to one layer, from extramucosal anastomosis to seromuscular anastomosis. With the rapid development of anastomosis instruments, the anastomosis process becomes more and more convenient. However, relevant studies have shown that related complications such as anastomotic leakage still occur. This study sought to investigate the feasibility and safety of seromuscular layer sutures in the reinforcement of esophagojejunostomy after open radical total gastrectomy. Methods: This study retrospectively analyzed patients who underwent Roux-en-Y esophagojejunostomy after open radical total gastrectomy at

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“…In 2020, the estimated number of new cases of GC was 1,089,103 worldwide, with a total of 768,793 deaths [2] . The standard therapy for proximal GC is total gastrectomy [3] with Roux-en-Y reconstruction, which has been widely used in gastrointestinal reconstruction [4] . Late-stage complications following total gastrectomy include anemia [5] , dumping syndrome [6] , reflux esophagitis [7] , and afferent loop syndrome [8] .…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Trans-Esophageal Gastrostomy for Oral Intake in a Case of Anastomotic Obstruction following Total Gastrectomy

Shishida

Sumitani

Yano

et al. 2023

Case Rep Gastroenterol

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Gastric cancer is one of the most common diseases globally. Total gastrectomy is often performed surgically. However, late-stage anastomotic passage obstruction after total gastrectomy is relatively rare. Here, we report a case involving a 73-year-old male patient who experienced repeated aspiration pneumonia due to anastomotic passage obstruction 22 years after a total gastrectomy for gastric cancer. He was eventually hospitalized in the Department of Gastroenterology at our hospital because of difficulty eating. Computed tomography revealed prominent dilation of the esophagus and the blind end of the elevated jejunum. Upper gastrointestinal endoscopy revealed a poorly extended site on the main side of the elevated jejunum; however, the passage through the scope was good. A percutaneous trans-esophageal gastrostomy was performed for oral intake. The patient experienced decreased nausea and vomiting. He gained weight, and his general condition improved. He did not feel inconvenienced by percutaneous trans-esophageal gastrostomy and had no desire for surgery. Follow-up observations are currently being conducted, with tubes exchanged every 6 months. There are no reports of percutaneous trans-esophageal gastrostomy for oral intake for anastomotic passage obstruction following total gastrectomy; therefore, we report this as a reference when similar cases are encountered.

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Improved anastomotic technique for esophagojejunal anastomosis using circular stapler

Cited by 4 publications

References 12 publications

Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer

Esophago-jejunal anastomosis with open approach using the parachute technique to prioritize safety after resection of esophagogastric junction cancer

Application value of continuous seromuscular layer sutures in the reinforcement of esophagojejunostomy in total gastrectomy for gastric cancer: a retrospective comparative cohort study

Percutaneous Trans-Esophageal Gastrostomy for Oral Intake in a Case of Anastomotic Obstruction following Total Gastrectomy

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