Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector183110.17816/KMJ1831Research ArticleOriginal method of esophagojejunal anastomosis after gastrectomy for stomach cancer, allowing post-operative complications preventionAkhmetzyanovF ShAkhmetzyanov@mail.ruBorisovV P-AkhmetzyanovaF F-BorisovS V-Kazan State Medical University, Kazan, RussiaVolga branch of the Russian Cancer Research Center named after N.N. Blokhin of the Russian Academy of Medical Sciences, KazanTatarstan Regional Clinical Cancer Center, Kazan, Russia1508201495450551028032016Copyright © 2014, Akhmetzyanov F.S., Borisov V.P., Akhmetzyanova F.F., Borisov S.V.2014Aim. To perform the comparative assessment of postoperative complications and mortality rate associated with two types of cuff esophagojejunal anastomosis after gastrectomy. Methods. Follow-up data of short-term post-operative complications rate in two groups of patients who underwent gastrectomy for gastric cancer, are described. Comparative results are presented on after gastrectomy in two groups of patients with gastric cancer: 193 patients were operated using the original method - single-row esophageal-intestinal anastomosis (main group), and 164 patients - using a double-row anastomosis (comparison group). Results. Among the patients who underwent an operation, 229 (64.1%) were older 60 years of age. Post-operative complications were observed in 25.4% of cases in the main group and in 36.6% of cases - in comparison group, including complications leading to unfavorable outcome - in 8.3 and 16.5% of cases, respectively. Post-surgical mortality in non-combined interventions was 5.1% in the main group and 13.7% in comparison group. After combined gastrectomy, post-surgical mortality was assessed as 10.5 and 17.7%, respectively. Early post-operative complications were subdivided into 2 groups: (1) associated with the method of anastomosis and (2) not associated with the method of anastomosis. The first group consisted of anastomosis suture failure, esophagojejunal anastomosis afferent loop obstruction syndrome, pancreatitits. Those complications were combined in one group because of pathogenesis unity. The number of such complications was lower by 2.2 times in the main group, including those with fatal outcome - by 3.2 times. Conclusion. Early post-surgical complications and mortality rate in patients who underwent gastrectomy with original method of single-row esophageal-intestinal anastomosis (main group) was significantly lower compared to patients who underwent gastrectomy with double-row anastomosis. Good reliability of the method of single-row esophageal-intestinal anastomosis allows to recommend its wide use in daily practice by surgeons and oncologists.stomach cancergastrectomyearly post-operative complicationsmortalityрак желудкагастрэктомияранние послеоперационные осложнениялетальность[Аксель Е.М., Давыдов М.И., Ушакова Т.И. Злокачественные новообразования желудочно-кишечного тракта: основные статистические показатели и тенденции // Соврем. онкол. - 2001. - Т. 3, №4. - С. 141-145.][Бондарь Г.В., Думанский Ю.В., Яковец Ю.И., Салиев Ю.А. Непосредственные результаты хирургического лечения рака желудка, осложнённого анемией // Клин. хир. - 1992. - №5. - С. 1-4.][Давыдов М.И., Тер-Ованесов М.Д., Маховский В.В. Состояние проблемы и пути оптимизации тактики хирургического лечения больных раком желудка старшей возрастной группы // Хирургия. - 2008. - №10. - С. 73-79.][Кавайкин А.Г., Сергеев И.В., Магдеев Р.Р. и др. Формирование анастомоза при операциях, выполненных по поводу рака проксимального отдела желудка и пищеводно-желудочного перехода // Казан. мед. ж. - 2008. - №1. - С. 33-37.][Сигал М.З., Ахметзянов Ф.Ш. Гастрэктомия и резекция желудка по поводу рака. Изд. 3-е, перераб. и доп. - Казань: Отечество, 2010. - 400 с.][Чарышкин А.Л., Гудошников В.Ю. Непосредственные результаты хирургического лечения рака желудка // Казан. мед. ж. - 2011. - №6. - С. 832-834.][Чернобровый Н.П., Мищенко Ф.Ф., Шаталюк Б.П. и др. Непосредственные результаты гастрэктомии при раке желудка // Вестн. хир. - 1988. - №2. - С. 20-23.][Черноусов Ф.А., Гучаков Р.В. Сравнительная оценка способов формирования эзофагоеюноанастомоза при гастрэктомии. Восстановительные и органосберегающие технологии - главный путь развития хирургии XXI века. - М., 2004. - 131 с.][Чёрный В.А., Щепотин И.Б. Пути снижения основных послеоперационных осложнений после гастрэктомии у больных раком желудка // Вестн. хир. - 1987. - №6. - С. 102-104.][Хоробрых Т.В., Левкин В.В., Ногтев П.В. и др. Несостоятельность швов пищеводно-кишечного анастомоза у больных раком тела желудка // Вестн. хир. гастроэнтерол. - 2012. - №1. - С. 58-65.]