Retrospective Study
Copyright ©The Author(s) 2017.
World J Gastroenterol. Oct 21, 2017; 23(39): 7129-7138
Published online Oct 21, 2017. doi: 10.3748/wjg.v23.i39.7129
Table 1 Characteristics, merit and demerit of different esophagojejunostomy anastomosis techniques
Anastomosis surgeonCharacteristicsMeritDemerit
Uyama et al[12]The anastomosis line is vertical with esophageal long axisAnastomotic is large enoughThe number of anastomosis linear staplers is much
Jejunum is located in the right side of the esophagus.
Matsui et al[37]Complete the anastomosis before severed esophagusThe number of anastomosis linear staplers is reducedProbably develop dysphagia 6 mo after operation
Close the stoma and resect specimens at the same time
Jejunum is located in the right side of the esophagus
Lee et al[13]Suture esophagus, jejunum and right angle of diaphragm after anastomosisReduce the incidence of esophageal hiatal hernia and anastomotic fistulaIncrease the operation time
Jejunum is located in the right side of the esophagus
Okabe et al[38]Before anastomosis, the specimens was removedThe size of anastomotic stoma is biggerThe technique is difficult
Jejunum is located in the left side of the esophagus
Inaba et al[29]Overlap anastomosisIsoperistaltic anastomosis meets the physiological needsThe jejunum is free and difficult for anastomosis
Divide the jejunum before anastomosis
Matsui et al[39]Overlap anastomosisIsoperistaltic anastomosis meets the physiological needsThe jejunum is free and difficult for anastomosis
Divide the esophagus after anastomosis
Table 2 Structure of EORTC QLC-C30 and EORTC QLQ-STO22
ScaleNumber of constituting items
EORTC QLQ-C30
Global health status/QoL scale12
Functional scales1
Physical functioning5
Role functioning2
Emotional functioning4
Cognitive functioning2
Social functioning2
Symptom scales2
Fatigue3
Nausea and vomiting2
Pain2
Dyspnoea1
Insomnia1
Appetite loss1
Constipation1
Diarrhoea1
Financial difficulties1
EORTC-QLQ-STO222
Dysphagia3
Chest and abdominal pain4
Reflux3
Eating restrictions4
Anxieties3
Dry mouth1
Taste problem1
Body image1
Hair loss2
Table 3 Demographic and clinical characteristics of patients in the two groups
All patients
Propensity-matched patients
Group T (n = 51)Group A (n = 456)P valueGroup T (n = 51)Group A (n = 102)P value
Age (mean ± SD, yr)55.5 ± 12.161.6 ± 11.2< 0.00155.5 ± 12.155.9 ± 11.00.916
Gender< 0.0011.000
Male343453468
Female171111734
Charlson comorbidity index0.2810.608
0484184892
1-2338310
BMI (mean ± SD, kg/m2)22.5 ± 13.122.3 ± 13.50.91922.5 ± 13.122.6 ± 12.80.965
Tumor size (mean ± SD, cm)4.5 ± 1.54.9 ± 1.30.0414.5 ± 1.54.7 ± 1.70.142
Tumor location< 0.0010.177
Upper third4188412
Middle third341693476
Whole13991314
Histology type0.4530.482
Differentiation474164797
Undifferentiation44045
Preoperative albumin (mean ± SD, g/L)40.8 ± 4.339.1 ± 5.20.02540.8 ± 4.340.6 ± 4.60.796
Depth of infiltration (T)0.1740.643
T115821523
T2883818
T3101351016
T4a181661845
Nodal status (N)0.7290.534
N0211902134
N111771118
N2566510
N3141231440
UICC stage0.3190.502
I13781318
II171591740
III212192144
Table 4 Operative variables of the patients
All patients
Propensity-matched patients
Group T (n = 51)Group A (n = 456)P valueGroup T (n = 51)Group A (n = 102)P value
Operative time, min (mean ± SD)209.3 ± 41.0203.6 ± 49.30.427209.3 ± 41.0200.5 ± 55.60.318
Blood loss, mL (mean ± SD)48.3 ± 38.598.4 ± 149.10.01748.3 ± 38.5105.4 ± 147.90.008
Harvested LNs (mean ± SD)44.5 ± 15.041.2 ± 14.20.23744.5 ± 15.042.6 ± 15.20.465
Time to first flatus, days (mean ± SD)3.8 ± 1.23.5 ± 1.70.2203.8 ± 1.23.6 ± 1.20.332
Time to fluid diet, days (mean ± SD)5.6 ± 1.45.6 ± 1.615.6 ± 1.45.5 ± 1.90.739
Postoperative days (mean ± SD)12.6 ± 4.314.7 ± 8.90.09712.6 ± 4.315.4 ± 8.90.035
hospitalization costs, yuan75450 ± 2003873308 ± 219320.50575450 ± 2003870407 ± 132540.065
Chemotherapy333100.63533780.123
Table 5 Morbidity and mortality associate with anastomosis
All patients
Propensity-matched patients
Group T, % (n = 456)Group A, % (n = 51)P valueGroup T, % (n = 102)Group A, % (n = 51)P value
Morbidity1 (2.0)27 (5.9)0.8931 (1.9)6 (11.8)0.552
Anastomotic fistula12214
Anastomotic hemorrhage0100
Anastomotic obstruction0402
Mortality00/00/
Table 6 Constituent items of pain of EORTC-QLQ-C30 and dysphagia of EORTC-QLQ-STO22 as compared between group T and group A
Propensity-matched patients
Group T (n = 44)Group A (n = 89)P value
Constituent items of pain of EORTC-QLQ-C30
Have you felt pain?0.018
Not at all2866
A little127
Quite a lot314
Very much12
Have your life affected by pain?0.271
Not at all3973
A little47
Quite a lot19
Very much00
Constituent items of dysphagia of EORTC-QLQ-STO22
Have you felt difficult to eat solid food?0.039
Not at all2631
A little1132
Quite a lot721
Very much05
Have you felt difficult to eat liquid of soft food?0.275
Not at all3867
A little515
Quite a lot17
Very much00
Have you felt difficult to drink water?0.194
Not at all3980
A little55
Quite a lot04
Very much00