BACKGROUND: Laparoscopic surgery has been increasingly applied to gastric cancer surgery. Gastrointestinal tract reconstruction totally done by laparoscopy also has been a challenge for those who developed this procedure. AIM: To describe simplified reconstruction after total or subtotal gastrectomy for gastric cancer by laparoscopy and the results of its application in a series of cases. METHODS: In the last four years, 75 patients were operated with gastric cancer and two with GIST. Thirty-four were women and 43 men. The age ranged from 38 to 77 years with an average of 55 years. In two patients with GIST a total and a subtotal gastrectomy were performed. In the other 75 patients were done 21 total gastrectomies and 54 subtotal. In all cancers, gastrectomy with D2 lymphadenectomy was completed with at least 37 lymph nodes removed. Was used in these operations a modified laparoscopic technique proposed by the authors consisting in a latero lateral esophagojejunal anastomosis with linear stapler in TG as well in STG, and reconstruction of the digestive continuity also in the upper abdomen. RESULTS: The intraoperative and immediate postoperative course were uneventful, except for one case of bleeding due to an opening clip, necessitating re-intervention. The operative time was 300 minutes, with no difference between total or subtotal gastrectomy. The number of lymph nodes removed varied from 28 to 69, averaging 37. Postoperative staging showed one case in T4 N2 M0; 13 in T2 N0 MO; 27 in T2 N1 M0; 24 in T3 N1 M0 and 10 in T3 N2 M0. Complication in only one case was observed on the 10th postoperative day with a small anastomotic leakage in esophagojejunal anastomose with spontaneous closure. CONCLUSION: The patient's evolution with no complications, no mortality and just one small anastomotic leakage with no systemic repercussions is a strong indication of the liability and feasibility of this innovative technical method.
BACKGROUND: Laparoscopic surgery has been increasingly applied to gastric cancer surgery. Gastrointestinal tract reconstruction totally done by laparoscopy also has been a challenge for those who developed this procedure. AIM: To describe simplified reconstruction after total or subtotal gastrectomy for gastric cancer by laparoscopy and the results of its application in a series of cases. METHODS: In the last four years, 75 patients were operated with gastric cancer and two with GIST. Thirty-four were women and 43 men. The age ranged from 38 to 77 years with an average of 55 years. In two patients with GIST a total and a subtotal gastrectomy were performed. In the other 75 patients were done 21 total gastrectomies and 54 subtotal. In all cancers, gastrectomy with D2 lymphadenectomy was completed with at least 37 lymph nodes removed. Was used in these operations a modified laparoscopic technique proposed by the authors consisting in a latero lateral esophagojejunal anastomosis with linear stapler in TG as well in STG, and reconstruction of the digestive continuity also in the upper abdomen. RESULTS: The intraoperative and immediate postoperative course were uneventful, except for one case of bleeding due to an opening clip, necessitating re-intervention. The operative time was 300 minutes, with no difference between total or subtotal gastrectomy. The number of lymph nodes removed varied from 28 to 69, averaging 37. Postoperative staging showed one case in T4 N2 M0; 13 in T2 N0 MO; 27 in T2 N1 M0; 24 in T3 N1 M0 and 10 in T3 N2 M0. Complication in only one case was observed on the 10th postoperative day with a small anastomotic leakage in esophagojejunal anastomose with spontaneous closure. CONCLUSION: The patient's evolution with no complications, no mortality and just one small anastomotic leakage with no systemic repercussions is a strong indication of the liability and feasibility of this innovative technical method.
Authors: Bruno Zilberstein; Carlos Malheiros; Laercio Gomes Lourenço; Paulo Kassab; Carlos Eduardo Jacob; Antonio Carlos Weston; Cláudio José Caldas Bresciani; Osvaldo Castro; Joaquim Gama-Rodrigues; Aldenis Albaneze Borin; Carlos Buchpiegel; André Montagnini; Celso Vieira Leite; Claudio Roberto Deutsch; Cleber Dario Pinto Kruel; Donato Mucerino; Durval Wohnrath; Elias Ilias; Fátima Mrué; Fauze Maluf-Filho; Felipe Rocha; Fernando de Souza; Flávio Saavedra Tomasich; Geraldo Ishak; Gustavo Laporte; Hamilton Petry de Souza; Ivan Cecconello; Jaime Eisig; Jorge Ohana; Jorge Sabagga; José Carlos del Grande; José Paulo de Jesus; José Soares; Luis Antonio Negrão Dias; Luiz Fernando Moreira; Mariangela Correa; Marineide Carvalho; Nelson Adami Andreollo; Nelson Dell Áquila; Nicolau Gregori Czeczko; Nicolau Kruel; Nora Manoukian Forones; Orlando Milhomem da Motta; Osvaldo Malafaia; Paulo Assumpção; Paulo Leonardi; Paulo Sakai; Paulo Roberto Savassi Rocha; Ramiro Colleoni; Roberto Gurgel; Roberto Pelegrini Coral; Sidney Chalub; Ulisses Ribeiro- Junior; Venancio Avancini Ferreira Alves; Vinicius de Lima Vasquez; Vladimir Nadalin Journal: Arq Bras Cir Dig Date: 2013 Jan-Mar
Authors: Paulo Kassab; Wilson Luiz da Costa; Carlos Eduardo Jacob; Roberto de Moraes Cordts; Osvaldo Antônio Prado Castro; Leandro Cardoso Barchi; Ivan Cecconello; Amir Zeide Charruf; Felipe José Fernández Coimbra; Antônio Moris Cury; Alessandro Landskron Diniz; Igor Correia de Farias; Wilson Rodrigues de Freitas; André Luis de Godoy; Elias Jirjoss Ilias; Carlos Alberto Malheiros; Marcus Fernando Kodama Pertille Ramos; Heber Salvador de Castro Ribeiro; André Roncon Dias; Fábio Rodrigues Thuler; Osmar Kenji Yagi; Laércio Gomes Lourenço; Bruno Zilberstein Journal: Transl Gastroenterol Hepatol Date: 2017-05-12
Authors: Marcus Vinicius Rozo Rodrigues; Valdir Tercioti-Junior; Luiz Roberto Lopes; João de Souza Coelho-Neto; Nelson Adami Andreollo Journal: Arq Bras Cir Dig Date: 2016 Apr-Jun