End-To-End Esophagojejunostomy Versus Standard End-To-Side Esophagojejunostomy: Which One Is Preferable?

• Main Authors: A. Kavyani, M. Talebian, M. Akbari, H. Khajooei Kermani, M. Aminseresht, M.R. Kalantar Motamedi, A. Saberi
• Format: Article
• Language: English
• Published: Iran University of Medical Sciences 2007-11-01
• Series: Medical Journal of The Islamic Republic of Iran
• Subjects: Total Gastrectomy; Alimentary Tract Reconstruction; Esophagojejunostomy; Dysphagia
• Online Access: http://mjiri.tums.ac.ir/browse.php?a_code=A-10-1-179&slc_lang=en&sid=1
• ISSN: 1016-1430; 2251-6840

Background:End-to-side esophagojejunostomy has almost always been associated with some degree of dysphagia. To overcome this complication we decided to perform an end-to-end anastomosis and compare it with end-to-side Roux-en-Y esophagojejunostomy. Methods: In this prospective study, between 1998 and 2005,71 patients with a diagnosis of gastric adenocarcinoma underwent total gastrectomy. Standard esophagojejunostomy with an end-to-side fashion was performed in 41 patients and compared with our recommended technique of end-to-end esophagojejunostomy in 30 patients. Results: This study showed that esophagojejunostomy with an end-to-end fashion has a low incidence of postoperative dysphagia (33.3%),whereas in those with an endto- side anastomosis the rate of ysphagia is very high (83%).Conclusion:A Roux-en-Y esophagojejunostomy with an end-to-end anastomosis has a low incidence of postoperative dysphagia and we strongly recommend using this technique.