J Korean Gastric Cancer Assoc.  2005 Dec;5(4):246-251.

Benign Stricture of Esophagojejunostomy after Radical Total Gastrectomy

• Oh SJ
• Baik YH
• Hong SK
• Choi MG
• Heo JS
• Noh JH
• Sohn TS
• Kim S
• Kim YI

Abstract

PURPOSE
Benign anastomotic stricture after an esophagojejunostomy using EEA stapler following a radical total gastrectomy is one of the most serious complications. The purpose of this study is to evaluate the incidence, risk factors, and treatment associated with benign stricture.
MATERIALS AND METHODS
From March 1998 to February 2001, 436 patients underwent an esophagojejunostomy with Roux-en-Y anastomosis using an EEA stapler followed by an endoscopy. Thirty three of the 436 patients (5.5%) developed an anastomotic stricture; included 24 of the 33 patients had a benign stricture. Nine patients with a malignant stricture were excluded.
RESULTS
The median age of the 436 patients was 57 years (23~85 years). Two hundred ninety two patients were male, and 144 patients were female. The median time to diagnosing the stricture was 1.5 months (0.5~6 months). There was no statistical significance in any of the risk factors, including the diameter of the stapling device, the status of adjuvant treatment, the status of reflux esophagitis, and a clinical history of diabetes and hypertension. The strictured patients were treated with balloon dilatation, one to three times, with symptom relief.
CONCLUSION
There were no statistically significant risk factors. However, further study of the vascularity of anastomoses and benign strictures needs to be considered. In the anastomotic strictured patients, endoscopic balloon dilatation appeared to be the first line of treatment.

Keyword

Benign stricture; Total gastrectomy; Esophagojejunostomy

MeSH Terms

Anastomosis, Roux-en-Y
Constriction, Pathologic*
Dilatation
Endoscopy
Esophagitis, Peptic
Female
Gastrectomy*
Humans
Hypertension
Incidence
Male
Risk Factors