TECHNIQUE FOR ESOPHAGOJEJUNOPLASTY IN GASTROECTOMY

The technique for esophagojejunoplasty in gastroectomy comprises the mobilization and gastroectomy, the tailoring of the reservoir with the aid of theintestinal graft. Esophagus jejunoanastomosis is then applied. After mobilization and gastroectomy, perimesenteric enteropexy at the distance of 21 cm is performed starting about 35 cm from Treitz ligament. The generated intestinal dublicature is flexed to the left followed by countermesenteric enteropexy. As a result P-shaped reservoir is generated at least 10 cm in length. The stump of the esophagus is dissected. Esophagoenteroanastomosis is applied between the left semicircle and the afferent loop, and between the right semicircle and the efferent loop of the flexed intestinal dublicature. Finally, the peritonization with the separate serous-muscular sutures is performed. In the distal division of the flexure of the efferent loop, the side-by-side intestinal anastomosis is applied. The anterior wall of esophagoenteroanastomosis is wrapped with the afferent intestinal part.