J Korean Soc Endosc Laparosc Surg.  2010 Jun;13(1):1-5.

Comparison of Complications in End-to-side and Side-to-side Esophagojejunostomy after Laparoscopy-assisted Total Gastrectomy for Gastric Cancer

• Park DJ
• Lee JH
• Lee MS
• Lee HJ
• Kim HH
• Yang HK

Abstract

PURPOSE
The aim of this study was to compare end-to-side with side-to-side esophagojejunostomy after laparoscopy-assisted total gastrectomy (LATG) for gastric cancer in terms of complications.
METHODS
One hundred and fourteen patients who underwent laparoscopy-assisted total gastrectomy for gastric cancer with curative intent from June 2003 to February 2010 at Seoul National University Bundang Hospital were retrospectively reviewed. Comparative analysis of short term outcomes including complications was performed to compare the end-to-side esophagojejunostomy (EJ) and side-to-side EJ groups.
RESULTS
Overall morbidity and mortality rates after LATG were 17.5% (20 patients) and 0%, respectively. Comparing the end-to-side EJ group (93 patients) with the side-to-side EJ group (21 patients), there was no significant difference in operating time (242.3 versus 250.7 minutes), estimated blood loss (176.6 versus 133.3 ml), time to first flatus (3.8 versus 4.0 days), time to first soft diet (5.3 versus 5.7 days), postoperative morbidity (15.1% versus 28.6%), and mortality. However, there was a difference in postoperative hospital stay (9.0 versus 12.9 days, p=0.045). Also, the EJ leakage rate of the side-to side EJ group was higher than that of end-to-side EJ group (14.3%, 3 patients, versus 2.2%, 2 patients; p=0.043).
CONCLUSION
End-to-side EJ can be recommended after LATG because the EJ leakage rate after end-to-side EJ was lower than that after side-to-side EJ.

Keyword

Laparoscopy-assisted total gastrectomy; Esophagojejunostomy; End-to-side; Side-to-side; Complication

MeSH Terms

Diet
Flatulence
Gastrectomy
Humans
Length of Stay
Retrospective Studies
Stomach Neoplasms