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Significance of intraoperative endoscopy in total gastrectomy for gastric cancer

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Abstract

Background

Anastomotic impairment can be a major cause of surgical complications in gastrointestinal surgery. The aim of this study was to evaluate the efficacy of intraoperative endoscopy (IOE) in esophagojejunal anastomosis for detection of anastomotic impairment.

Methods

Forty-eight patients who underwent total gastrectomy were evaluated for the integrity of the esophagojejunostomy using IOE at completion of mechanical esophagojejunal anastomosis.

Results

Overall postoperative anastomotic leakage (PAL) rate was 4.2% (n = 2/48). Both patients who developed PAL had abnormal findings such as mucosal defect in the esophageal mucosa or incomplete anastomotic stapling. Also, IOE revealed inadvertent anastomotic failure in three patients: two jejunal and one esophageal occlusion. There were no complications due to IOE.

Conclusion

IOE is safe and may easily provide significant information that can minimize PAL by detecting anastomotic failure on esophagojejunal anastomosis.

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Disclosures

K. Nishikawa, K. Yanaga, H. Kashiwagi, N. Hanyuu, and S. Iwabuchi have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi Minato-ku, Tokyo, 105-8471, Japan

    Katsunori Nishikawa, Katsuhiko Yanaga & Hideyuki Kashiwagi

  2. Division of Surgery, Machida Municipal Hospital, 2-15-41 Asahimachi, Machida-shi, Tokyo, 194-0023, Japan

    Nobuyoshi Hanyuu & Shuuichi Iwabuchi

Authors
  1. Katsunori Nishikawa
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  2. Katsuhiko Yanaga
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  3. Hideyuki Kashiwagi
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  4. Nobuyoshi Hanyuu
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  5. Shuuichi Iwabuchi
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Correspondence to Katsunori Nishikawa.

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Nishikawa, K., Yanaga, K., Kashiwagi, H. et al. Significance of intraoperative endoscopy in total gastrectomy for gastric cancer. Surg Endosc 24, 2633–2636 (2010). https://doi.org/10.1007/s00464-010-1007-0

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  • DOI: https://doi.org/10.1007/s00464-010-1007-0

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