275 results match your criteria roux-en-y esophagojejunostomy


Primary gastric melanoma with pancreatic metastasis: a case report.

Ann Palliat Med 2021 May;10(5):5902-5907

Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China.

We report an extremely rare case of primary gastric melanoma with pancreatic metastasis. As far as we know, the concept of primary gastrointestinal melanoma is currently controversial, because there are very few reports of primary gastrointestinal melanoma. At the same time, isolated pancreatic metastases are also very rare. Read More

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Gastric remnant mesentero-axial volvulus following Roux-en-Y esophagojejunostomy: A rare complication.

Int J Surg Case Rep 2021 May 7;82:105873. Epub 2021 Apr 7.

Esophageal Institute, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address:

Introduction: Acute gastric volvulus is a surgical emergency with a mortality as high as 15-20%. The rarity of gastric volvulus requires high index of clinical suspicion especially in the patients with altered anatomy, to allow immediate surgical intervention and reduce the morbidity and mortality.

Presentation Of Case: We present an unusual case of gastric remnant volvulus several months following Roux-en-Y esophagojejunostomy performed in an obese patient for severe, recurrent gastroesophageal reflux disease (GERD) and failed prior fundoplication. Read More

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Risk factors for esophagojejunal anastomotic leakage after curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.

J Int Med Res 2021 Mar;49(3):3000605211000883

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital and Institute, Beijing, China.

Objective: To explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) after curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.

Methods: We reviewed the data for 390 consecutive patients undergoing Roux-en-Y esophagojejunostomy reconstruction after total gastrectomy. Multivariate analysis was performed using a logistic regression model to identify the independent risk factors for EJAL. Read More

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Differences in intestinal microbiota profiling after upper and lower gastrointestinal surgery.

J Chin Med Assoc 2021 Apr;84(4):354-360

Department of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC.

Background: We aimed to investigate the long-term effects of metabolic profiles and microbiota status in patients after upper gastrointestinal (GI) surgery and lower GI surgery and compared them with a control group.

Methods: In this cross-sectional study, we analyzed the occurrence of metabolic syndrome (MS) in 10 patients who underwent curative total gastrectomy with Roux-en-Y esophagojejunostomy (RYEJ) anastomosis, 11 patients who underwent curative partial colectomy with right hemicolectomy (RH), and 33 age- and sex-matched controls. Fecal samples were also analyzed by a next-generation sequencing method. Read More

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Feasibility and quality of life assessment of laparoscopic proximal gastrectomy using double-tract reconstruction.

Langenbecks Arch Surg 2021 Mar 15;406(2):479-489. Epub 2021 Jan 15.

Gastric Surgery Division, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan.

Purpose: As the frequency of cancer in the proximal stomach or around the esophagogastric junction (EGJ) increases worldwide, the use of laparoscopic proximal gastrectomy (LPG) has expanded. This study evaluated the safety of LPG with double-tract reconstruction (LPG-DT) and the resulting quality of life (QOL) of patients.

Methods: In this retrospective cohort study, we reviewed the data of patients who underwent LPG-DT via linear-stapled esophagojejunostomy for gastric or EGJ cancer between 2013 and 2019, and outcomes were compared with those of laparoscopic total gastrectomy with Roux-en-Y reconstruction (LTG-RY) peMME000372rformed over the same period. Read More

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Laparoscopic Completion Total Gastrectomy for Remnant Gastric Cancer.

J Laparoendosc Adv Surg Tech A 2020 Nov 24. Epub 2020 Nov 24.

Cancer Institute, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.

Remnant gastric cancer (RGC) is increasing due to past use of subtotal gastrectomy to treat benign diseases, improvements in the detection of gastric cancer, and increased survival rates after gastrectomy for gastric cancer. Laparoscopic access provides the advantages and benefits of minimally invasive surgery. However, laparoscopic completion total gastrectomy (LCTG) for RGC is technically demanding, even for experienced surgeons. Read More

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November 2020

A Comparison of the Short-Term Clinical Effects Between Totally Laparoscopic Radical Gastrectomy With Modified Roux-en-Y Anastomosis and Laparoscopic-Assisted Radical Gastrectomy With Roux-en-Y Anastomosis.

Technol Cancer Res Treat 2020 Jan-Dec;19:1533033820973281

Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China.

Objective: To compare the short-term clinical effects between totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis, and laparoscopic-assisted radical gastrectomy with Roux-en-Y anastomosis; to explore the safety, feasibility and short-term effect of totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis.

Methods: Data of 75 patients who underwent totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis, and 95 patients who underwent laparoscopic-assisted radical gastrectomy with Roux-en-Y anastomosis by the same surgical team were analyzed. During the modified Roux-en-Y anastomosis, the stomach separation and regional lymph node dissection were completed under a laparoscope; the specimen was placed in a bag; gastrojejunostomy was completed; the subumbilicus hole was enlarged to 3 cm; the specimen was taken out; then, the proximal and distal ends of the small intestine were moved outside of the abdominal wall to complete the small intestine-small intestine end-to-side anastomosis. Read More

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November 2020

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options.

Obes Surg 2021 Jan 29;31(1):357-369. Epub 2020 Oct 29.

Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.

This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Read More

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January 2021

Short-Term and Quality of Life Outcomes of Patients Using Linear or Circular Stapling in Esophagojejunostomy after Laparoscopic Total Gastrectomy.

J Gastrointest Surg 2020 Sep 28. Epub 2020 Sep 28.

Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xinsi Road No.1, Baqiao District, Xi'an, 710038, China.

Background: Studies comparing the incidence of reflux esophagitis (RE) and patients' quality of life (QoL) when using circular stapler (CS) and linear stapler (LS) in esophagojejunostomy (EJS) after laparoscopic total gastrectomy (LTG) are rare, and certainly there are not enough to make a definitive decision on best practice. Presented herein is a study on the comparison of the short-term outcomes, QoL of the patients with the focus on the incidence of RE after both linear and circular stapling in LTG.

Methods: From January 2014 to October 2018, 120 patients were analyzed; of these, 42 patients underwent laparoscopy-assisted total gastrectomy (LATG) with CS (CS group) and 78 patients who underwent totally laparoscopic total gastrectomy (TLTG) with LS (LS group). Read More

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September 2020

Emergency esophagojejunostomy in type IV hiatal hernia: A case report.

Cir Cir 2020 ;88(Suppl 1):14-18

Departamento Cirugía General, Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Cundinamarca, Colombia.

Reconstruction of the digestive tract is a surgical challenge; we propose a novel and successful alternative using a large vascularized pedicled jejunum anastomosed to the cervical esophagus in an emergency situation. A 65-year-old female patient in follow-up due to a gigantic type IV paraesophageal hernia, whom underwent surgical hernial defect correction, had friable gastric tissue and esophageal lesions that forced an urgent esophagojejunostomy. Immediate post-operative recovery had no incidents and during the outpatient follow-up no complications were reported. Read More

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January 2020

Endoscopic Surveillance of Duodenal Polyposis After Total Gastrectomy in Familial Adenomatous Polyposis.

ACG Case Rep J 2020 Aug 20;7(8):e00445. Epub 2020 Aug 20.

Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH.

The lifetime incidence of duodenal polyposis in familial adenomatous polyposis (FAP) approaches 100%, and duodenal cancer is the most common malignancy once colectomy is performed. The incidence of gastric cancer is increasing in patients with FAP, and when gastric polyps with high-grade dysplasia or cancer are present, a total gastrectomy with Roux-en-Y esophagojejunostomy is indicated. The altered anatomy after surgery and presence of adhesions from a previous colectomy make endoscopic surveillance of the duodenum with standard equipment difficult. Read More

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Percutaneous transesophageal gastro-tubing for the management of anastomotic leakage after upper GI surgery: a report of two clinical cases.

Surg Case Rep 2020 Aug 24;6(1):214. Epub 2020 Aug 24.

Department of Surgery, Osaka City Juso Hospital, 2-12-27, Nonaka-kita, Yodogawa-ku, Osaka, 532-0034, Japan.

Background: Anastomotic leakage is a serious, sometimes critical complication of upper gastrointestinal (GI) surgery. The cavity and target drainage tubes are difficult to reach; therefore, a nasogastric tube (NGT) and fasting are required for an extended period. We successfully treated and managed two patients with anastomotic leakage using percutaneous transesophageal gastro-tubing (PTEG). Read More

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Sleeve Gastrectomy Combined with Nissen Fundoplication as a Single Surgical Procedure, Is It Really Safe? A Case Report.

Am J Case Rep 2020 Jun 23;21:e923543. Epub 2020 Jun 23.

Department of General Surgery, "M. Rubino" University Hospital Polyclinic of Bari, Bari, Italy.

BACKGROUND Laparoscopic sleeve gastrectomy (LSG) has become the most common surgical procedure performed in bariatric surgery. Large hiatal hernias and Barrett's esophagus are the only contraindications recognized among experts. However, some studies have suggested that LSG may exacerbated gastroesophageal reflux disease (GERD) symptoms or induce postoperative GERD de novo. Read More

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Outcomes of reoperative surgery in severely obese patients after sleeve gastrectomy: a single-institution experience.

Surg Obes Relat Dis 2020 Aug 4;16(8):983-990. Epub 2020 May 4.

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida. Electronic address:

Background: Despite its popularity, sleeve gastrectomy (SG) is not devoid of postoperative complications and weight regain. Some of these cases warrant conversion to Roux-en-Y gastric bypass or proximal gastrectomy with Roux-en-Y esophagojejunostomy. Complications after conversion are scarcely reported in the literature. Read More

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[Short-Term Outcomes of Laparoscopic-Assisted Total Gastrectomy Using the Endoscopic Purse-String Suture Instrument ENDO-PSI].

Gan To Kagaku Ryoho 2019 Dec;46(13):2503-2505

Dept. of Surgery, Yokohama Minami Kyousai Hospital.

Laparoscopic-assisted total gastrectomy(LATG)has several complications early during the introduction of the procedure, so a careful approach is necessary. In this study, we evaluated short-term outcomes after LATG at our hospital. From 2014 to 2017, 21 patients underwent LATG using ENDO-PSI. Read More

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December 2019

Laparoscopic gastrectomy using intracorporeally hand-sewn anastomosis of esophagojejunostomy, gastroduodenostomy, or gastrojejunostomy for gastric cancer.

Medicine (Baltimore) 2020 Jan;99(5):e19002

Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.

Laparoscopic gastrectomy (LG) using intracorporeal anastomosis has recently become more prevalent due to the advancements of laparoscopic surgical instruments. However, intracorporeally hand-sewn anastomosis (IHSA) is still uncommon because of technical difficulties. In this study, we evaluated various types of IHSA following LG with respect to the technical aspects and postoperative outcomes. Read More

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January 2020

Laparoscopic Roux-en-Y reconstruction using conventional linear stapler in robotic total gastrectomy for gastric cancer.

Surg Oncol 2020 Jun 19;33:9-10. Epub 2019 Dec 19.

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Background: Robotic stapling devices have been designed to create staple formation equivalent to conventional laparoscopic stapling. In gastric cancer surgery, however, any advantages the robotic stapler has in maneuverability compared to standard laparoscopic stapling devices remain unclear [1]. We applied robotic-assisted laparoscopic stapling techniques during reconstruction after robotic total gastrectomy (RTG) for gastric cancers (GCs) as "fusion surgery". Read More

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[Redo reconstruction of the digestive tract after gastric surgery].

Khirurgiia (Mosk) 2019 (12):37-46

Vishnevsky National Research Surgical Center, Moscow, Russia.

Objective: To formulate the concept of physiological reconstruction of the digestive tract during redo gastric surgery.

Material And Methods: There were 52 patients who underwent redo gastric surgery after previous resections, drainage and antireflux procedures in 2011-2017 at the Vishnevsky National Research Surgical Center. Redo resection of the stomach with Billroth-1 and Hofmeister reconstructions were performed in 5 (9. Read More

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December 2019

Linear or circular stapler? A propensity score-matched, multicenter analysis of intracorporeal esophagojejunostomy following totally laparoscopic total gastrectomy.

Surg Endosc 2020 12 9;34(12):5265-5273. Epub 2019 Dec 9.

Department of Surgery, Graduate School of Medicine, Kyoto University, 54, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Background: Presently, there is no consensus as to what procedure of intracorporeal esophagojejunostomy (EJS) in totally laparoscopic total gastrectomy (TLTG) is best to reduce postoperative complications. The aim of this study was to demonstrate the superiority of linear stapled reconstruction in terms of anastomotic-related complications for EJS in TLTG.

Methods: We collected data on 829 consecutive gastric cancer patients who underwent TLTG reconstructed by the Roux-en-Y method with radical lymphadenectomy between January 2010 and December 2016 in 13 hospitals. Read More

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December 2020

Gastric necrosis late after a Collis-Nissen procedure.

J Surg Case Rep 2019 Oct 17;2019(10):rjz272. Epub 2019 Oct 17.

Digestive Surgery Service, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.

A Nissen procedure is an efficient surgical approach to treat gastroesophageal reflux disease. It is sometimes combined with a Collis gastroplasty to lengthen the functional distal esophagus to allow a 360° Nissen fundoplication without tension. We present the case of a 76-year-old female patient, with a history of a Collis-Nissen procedure, who developed extensive gastric necrosis after ingesting a significant quantity of maize. Read More

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October 2019

Comparison of Functional Outcomes between Functional Jejunal Interposition and Conventional Roux-en-Y Esophagojejunostomy after Total Gastrectomy for Gastric Cancer.

Dig Surg 2020 15;37(3):240-248. Epub 2019 Oct 15.

Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.

Background: The reconstruction of digestive tract after total gastrectomy is associated with various postoperative complications. We aimed to investigate the differences in functional outcomes of 2 reconstruction techniques following total gastrectomy: functional jejunal interposition (FJI) versus Roux-en-Y esophagojejunostomy.

Methods: Sixty patients were enrolled and divided into FJI and Roux-en-Y groups. Read More

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A Novel Technique of Hand-Sewn Purse-String Suturing by Double Ligation Method (DLM) for Intracorporeal Circular Esophagojejunostomy.

J Gastric Cancer 2019 Sep 9;19(3):290-300. Epub 2019 Aug 9.

Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan.

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus.

Materials And Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). Read More

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September 2019

Hemi-double stapling technique performed with a transorally inserted anvil for esophagojejunostomy in the surgical treatment of gastric cancer.

Asian J Endosc Surg 2020 Apr 16;13(2):168-174. Epub 2019 May 16.

Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Introduction: A transorally inserted anvil has been developed to facilitate the creation of a stapled anastomosis without the need for a purse string to secure the anvil into place during laparoscopic total gastrectomy (LTG). We describe a hemi-double stapling technique and application of a transorally inserted anvil for esophagojejunostomy during LTG, and we report the results of a retrospective study in which we examined the feasibility and safety of this method. We also describe the key technical details of the method. Read More

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Incarcerated Hiatal Hernia with Perforation after Laparoscopic Total Gastrectomy with Roux-en-Y Reconstruction: a Case Report.

J Gastric Cancer 2019 Mar 19;19(1):132-137. Epub 2019 Mar 19.

Department of Surgery, Division of General Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (R.O.C.).

The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Read More

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[Application of intracorporeal uncut Roux-en-Y anastomosis in digestive tract reconstruction after laparoscopic total gastrectomy].

Zhonghua Wei Chang Wai Ke Za Zhi 2019 Jan;22(1):43-48

Department of Oncology Surgery, Fujian Provincial Hospital, Fuzhou 350001,

Objective: To explore the safety, feasibility and short-term efficacy of intracavitary uncut Roux-en-Y (URY) anastomosis in digestive tract reconstruction following laparoscopic total gastrectomy (LTG).

Methods: From November 2015 to January 2018, 67 gastric cancer patients underwent intracavitary URY following LTG to reconstruct the digestive tract at Oncological Surgery Department of Fujian Provincial Hospital. There were 41 males and 26 females with age of 50 to 81 (61. Read More

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January 2019

Robot-Assisted Total Gastrectomy: Preliminary Evaluation.

J Laparoendosc Adv Surg Tech A 2019 May 31;29(5):589-594. Epub 2018 Dec 31.

Service de Chirurgie Digestive, Endocrinienne et Thoracique, Centre Hospitalier Régional, Orleans, France.

Laparoscopic total gastrectomy with extended lymphadenectomy is a technically demanding surgical procedure with steep learning curve that has limited its widespread use. The aim of this study was to evaluate the feasibility of the robotic approach in total gastrectomy for cancer. We present our experience of 17 consecutive patients who underwent robotic total gastrectomy with intracorporal sutured Roux-en-Y esophagojejunostomy and jejuno jejunostomy between 2014 and 2017. Read More

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Esophageal Metallic-Stent Migration: a Rare Cause of Anal Pain in a Patient with Gastric Cancer.

Indian J Surg Oncol 2018 Dec 16;9(4):576-577. Epub 2018 May 16.

2Department of Surgery, Hospital General Tacuba, ISSSTE, Mexico City, Mexico.

Stents are a great development for esophageal fistula treatment; however, stent migration is a frequent complication. A stent migration that caused anal pain is presented. A 79-year-old man with poorly differentiated gastric carcinoma was submitted to a total gastrectomy with a Roux-en-Y esophagojejunostomy. Read More

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December 2018

Incarcerated paraesophageal hernia complicated by pancreatic damage and unusual comorbidity: Two retrospective case series.

Int J Surg Case Rep 2019 30;54:75-78. Epub 2018 Nov 30.

Department of Pediatric and Gastrointestinal Surgery, Oslo University Hospital, Ullevål, P.O. box 4950, 0424 Oslo, Norway. Electronic address:

Introduction: About 1% of paraesophageal hernias (PEH) require emergency surgery due to obstruction or gangrene. We present two complicated cases of incarcerated PEH. Presentation of cases: A patient aged 18 with trisomy 21 was admitted after four days of vomiting and epigastric pain. Read More

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November 2018

Stenosis after esophagojejunostomy with the hemi-double-stapling technique using the transorally inserted anvil (OrVil™) in Roux-en-Y reconstruction with its efferent loop located on the patient's left side following laparoscopic total gastrectomy.

Surg Endosc 2019 07 19;33(7):2128-2134. Epub 2018 Oct 19.

Department of Surgery, Otori Stomach and Intestines Hospital, 653-1 Kami, Nishi-ku, Sakai, Osaka, 593-8311, Japan.

Background: The drawback of intracorporeal esophagojejunostomy with the double-stapling technique (DST) using a transorally inserted anvil (OrVil™, Covidien, Mansfield, MA, USA) following laparoscopic total gastrectomy (LTG) is not only the high incidence of stenosis but also the presence of intractable stenosis that is refractory to endoscopic treatments.

Methods: From November 2013 to December 2016, 24 patients with gastric cancer underwent intracorporeal circular-stapled esophagojejunostomy with the hemi-double-stapling technique (hemi-DST) using the OrVil™ in antecolic Roux-en-Y reconstruction with its efferent loop located on the left side of the patient following LTG to prevent twisting of the esophagojejunostomy and lifted jejunum, which might cause intractable stenosis of the esophagojejunostomy.

Results: In this patient series, no twisting of the esophagojejunostomy and lifted jejunum was encountered intraoperatively or postoperatively. Read More

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