147- Anastomose the distal esophagus to the jejunum at the enter-
ostomy site. This will be an end-to-side anastomosis, with 4–8
interrupted through-and-through 7-0 to 10-0 polypropylene
sutures. Place two sutures on the corner, three on the dorsal
side, and three on the front. - After confirmation of hemostasis, close the abdominal wall and
the skin separately with 6-0 absorbable suture (e.g., Vicryl,
Ethicon, Somerville, NJ) (see Notes 3– 6 ). - Follow steps 1– 3 in Subheading 3.2 to expose the distal
esophagus. - Make two 5-mm longitudinal incisions: one on the distal
esophagus and one on the proximal end of the duodenum, on
the anti-mesenteric border. - Anastomose the incisions with accurate mucosal-to-mucosal
opposition. This will be a side-to-side anastomosis, with 5–7
interrupted through-and-through 8-0 polypropylene sutures.
Place 3–4 sutures on the dorsal side and 2–3 on the front. - After confirmation of hemostasis, close the abdominal wall and
the skin separately with 6-0 Vicryl.
3.3 Esophagogastr-
oduodenal
Anastomosis: dGER
(Fig. 2 ) [ 18 , 21 ]
Fig. 1 Esophagojejunostomy (used with permission from Norton Thoracic
Institute, Phoenix, Arizona)Reflux Mouse Models in Esophageal Adenocarcinoma