Safety of transorally-inserted anvil for esophagojejunostomy in laparoscopic total gastrectomy

Y. Kwon, S. I. Cho, Y. J. Kwon, K. S. Yang, Y. J. Jang, J. H. Kim, S. H. Park, Y. J. Mok, S. Park

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background To assess the safety of transorally-inserted anvil (TOA) for use during esophagojejunostomy (EJ) reconstruction during laparoscopic total gastrectomy (LTG). Methods Between March 2009 and December 2011, 39 consecutive open total gastrectomies (OTGs) and 36 LTGs using TOA for gastric cancer were comparatively evaluated. We investigated postoperative complications, using the Clavien-Dindo classification. To evaluate the effect of a learning period in using TOA for LTG, we also investigated shifts in the patterns of complications and changes in total operation time over the course of the study. Results The patient characteristics at baseline were not different between both groups, except for the extent of lymphadenectomy (P < 0.001) and depth of tumor invasion (P = 0.003). Multivariate analysis revealed that TOA usage elevated the occurrence of infectious complications significantly (OR = 3.32, P = 0.042), but was not associated with EJ-related complications. TOA usage did not need a learning period for the length of time required to complete the operation, or the likelihood of developing an EJ-related or infectious complication. Conclusions TOA use for EJ during LTG is relatively simple and easy enough not to require a learning period for surgeons. This procedure did not elevated the occurrence of EJ-related complications compared to circular stapling in open surgery, but it does require special prevention efforts to avoid infectious complications.

Original languageEnglish
Pages (from-to)330-337
Number of pages8
JournalEuropean Journal of Surgical Oncology
Issue number3
Publication statusPublished - 2014 Mar
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by National Research Foundation of Korea Grant, funded by the Korean Government (2010-0024825).


  • Gastrectomy
  • Laparoscopy
  • Surgical anastomosis

ASJC Scopus subject areas

  • Surgery
  • Oncology


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