Choosing a method to perform an esophageal-intestinal anastomosis after complete removal of the stomach

Abstract

The paper reviews various methods of performing esophageal-intestinal anastomoses with complete removal of the stomach (gastrectomy). The main methods of manual and stapler stitching of the esophagus with the jejunum are described. Special attention is paid to detailing of techniques for the most commonly performed esophageal-intestinal anastomoses, with a  comparative assessment of the reliability of manual and stapler anastomoses. Given the large number of proposed methods to perform esophageal-intestinal anastomoses, it can be stated that no universal anastomosis yet exists. In laparotomy, a stapler suture is most commonly used to perform an esophageal-intestinal anastomosis with circular crosslinking devices, while the manual version implies one of the invagination techniques, or muff-like anastomosis (the Tsatsanidi K.N., Bondar G.V., Davydov M.I. procedure). With laparoscopic access, the anastomosis is performed with linear endoscopic crosslinking devices. The choice of a technique to perform an esophageal-intestinal joint remains with the operating surgeon and depends on his/hers experience, skills, individual intraoperative situation, and equipment of the operating unit.