Technical Note: ‘Cut And Sew’ Technique In The Resection Of Esophagogastric Junction Tumours Via Transabdominal Approach Alone

• Published in: Archives of the Balkan Medical Union : the official journal of the Balkan Medical Union Vol. 55; no. 2; pp. 358 - 360
• Main Authors: HATIPOGLU, Engin, ERTEM, Metin, ERGUNEY, Sabri
• Format: Journal Article
• Language: English
• Published: Balkan Medical Union 01.06.2020
• Subjects: esophagogastric junction tumours; high esophago-jejunal anastomosis; technical contribution
• ISSN: 1584-9244; 2558-815X
• DOI: 10.31688/ABMU.2020.55.2.23

Introduction. In the surgery of esophagogastric junction tumours, obtaining a tumour-free proximal surgical margin and determining the right approach to reach this goal may be challenging. The objective of the study was to make a technical contribution to the performance of high esophago-jejunal anastomoses via transabdominal approach alone, following resection of esophagogastric junction tumours. We named this technique as the „cut and sew“ technique. Material and methods. Between January 2015 and December 2017, 113 patients were operated with curative intent for gastric cancer in our surgical unit. Distal gastrectomy was performed in 41 patients, while 51 patients underwent total gastrectomy. The remaining 21 patients, who constitute the subjects of this study, presented with a Siewert type II (8 patients) or a Siewert type III (13 patients) esophagogastric junction tumour. Results. One patient in the neoadjuvant chemoradiotherapy group, with additional thoracotomy, died because of pulmonary complications and respiratory failure. No mortality or any significant morbidity was seen in the group operated transabdominally alone. Conclusions. The „cut and sew“ technique is efficient and safe in performing high esophago-jejunal anastomosis following resection of Siewert type 2 and 3 esophagogastric junction tumours, through abdominal approach alone. The omission of an additional thoracic route decreases the morbidity and eventually the mortality.