Stenosis of esophago-jejuno anastomosis after gastric surgery

World J Surg. 2010 Aug;34(8):1859-63. doi: 10.1007/s00268-010-0609-y.

Abstract

Background: Stenosis of esophago-jejuno anastomosis is one of the postoperative complications of gastric surgery. This complication usually manifests with the symptom of dysphagia and is treated by endoscopic dilatation. No large-scale studies have been conducted to determine the incidence of this complication after surgery.

Methods: The data of a total of 1478 consecutive patients who underwent total, proximal, or completion gastrectomy, including esophago-jejuno anastomosis, between 2000 and 2008 were analyzed retrospectively with a view to determining the incidence of anastomotic stenosis.

Results: Sixty patients (4.1%) developed stenosis of the esophago-jejuno anastomosis which needed to be treated by endoscopic balloon dilatation. The average interval between the surgery and detection of stenosis was 67.4 days (median = 58.0). Multivariate analysis identified female gender, proximal gastrectomy, use of a narrow-sized stapler, and the choice of the stapling device as significant factors influencing the risk of development of anastomotic stenosis.

Conclusion: Esophago-jejuno anastomotic stenosis appears to be a common late postoperative complication after gastric surgery. Endoscopic examination and treatment yielded favorable outcomes in patients complaining of dysphagia after gastric surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Catheterization*
  • Chi-Square Distribution
  • Constriction, Pathologic / epidemiology
  • Constriction, Pathologic / therapy
  • Esophageal Diseases / epidemiology
  • Esophageal Diseases / therapy*
  • Female
  • Fluoroscopy
  • Gastrectomy*
  • Humans
  • Incidence
  • Jejunal Diseases / epidemiology
  • Jejunal Diseases / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / surgery*
  • Surgical Stapling
  • Treatment Outcome