Application of Arch-Preserved Jejunum in Total Gastrectomy with Roux-en-Y Esophagojejunostomy

Objective To explore the feasibility of arch-preserved jejunum in total gastrectomy with Roux-en-Y esophagojejunostomy for adenocarcinoma of esophagogastric junction(AEG)and upper-middle gastric cancer.Methods Clinical data of 13 patients who underwent total gastrectomy with Roux-en-Y esophagojejunostomy with usage of archpreserved jejunum to resolve the anastomosis tension problem in our hospital from Dec.2012 to Apr.2013 were analyzed retrospectively,and surgical experience was summarized.Results The maximal and actual extended lengths were(7.75±1.75)cm(4-10 cm)and(5.95±1.82)cm(3-9 cm)respectively,with the utilization percentage of(77.91± 16.60)%(50.0%-100.0%).These patients hadn’t suffered postoperative mortality and severe complications,such as anastomosis leakage,stenosis,hemorrhage,and so on.Besides,there were 1 case complicated with postoperative acute urinary retention and another 1 case complicated with infra-hepatic space abscess and peritoneal infection.Conclusion Arch-preserved jejunum is a practical surgical technique to handle with the anastomosis tension of esophagojejunostomy in total gastrectomy for AEG and upper-middle gastric cancer.