Technical and Survival Risks Associated With Esophagojejunostomy by Laparoscopic Total Gastrectomy for Gastric Carcinoma.

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.