Re-do laparoscopic esophagojejunostomy for anastomotic stenosis after laparoscopic total gastrectomy in gastric cancer

Purpose Anastomotic stenosis of esophagojejunostomy after total gastrectomy has a substantial impact on the postoperative quality of life of the patient. If conservative treatment doesn’t work, surgical intervention should be considered. However, redoing esophagojejunostomy is an extremely demanding...

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Bibliographic Details
Published in:Langenbeck's archives of surgery 2022-11, Vol.407 (7), p.3133-3139
Main Authors: Manaka, Dai, Konishi, Sayuri, An, Hideo, Kawaguchi, Kiyotaka, Yoneda, Machi, Fushitani, Masashi, Ota, Takano, Morioka, Michina, Okamura, Yusuke, Ikeda, Atsushi, Sasaki, Naoya, Hamasu, Shinya, Nishitai, Ryuta
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
General Surgery
How-I-Do-It articles
Medicine
Medicine & Public Health
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
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Summary:Purpose Anastomotic stenosis of esophagojejunostomy after total gastrectomy has a substantial impact on the postoperative quality of life of the patient. If conservative treatment doesn’t work, surgical intervention should be considered. However, redoing esophagojejunostomy is an extremely demanding procedure. Especially in the case where the primary surgery was performed laparoscopically, it is an unmet problem to maintain minimal invasiveness in re-do surgery. Methods We report 3 cases of re-do esophagojejunostomy laparoscopically performed for anastomotic stenosis after laparoscopic total gastrectomy in gastric cancer, in whom endoscopic balloon dilation did not work. Results Each patient underwent a re-do esophagojejunostomy laparoscopically. The mean operation time was 293 min, and the mean blood loss was 56 ml. There was no anastomosis-related complication, and they were discharged from hospital on 11–16 postoperative days. At the time of discharge, oral food intake was 100% in each patient. One year after the operation, follow-up endoscopic exams showed no anastomotic stenosis. Conclusion Re-do laparoscopic esophagojejunostomy for anastomotic stenosis after laparoscopic total gastrectomy was safely and successfully performed. It brings patients minimal invasiveness continuously from the initial surgery. Re-do laparoscopic esophagojejunostomy could be one of the options for anastomotic stenosis resistant to conservative treatment.
ISSN:1435-2451
1435-2451
DOI:10.1007/s00423-022-02632-3