Takeru Matsuda1, Takeshi Iwasaki2, Masaaki Mitsutsuji2, Kenro Hirata2, Yoko Maekawa2, Daisuke Tsugawa2, Yutaka Sugita2, Etsuji Shimada2, Yoshihiro Kakeji3. 1. Department of Surgery, National Hospital Organization Kobe Medical Center, 3-1-1 Nishi-Ochiai, Suma-ku, Kobe, 654-0155, Japan. takerumatsuda@nifty.com. 2. Department of Surgery, National Hospital Organization Kobe Medical Center, 3-1-1 Nishi-Ochiai, Suma-ku, Kobe, 654-0155, Japan. 3. Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract
BACKGROUND: Esophagojejunostomy in laparoscopic total gastrectomy (LTG) is a technically demanding procedure. Although several methods have been reported to date, none is considered consistently reliable. We developed a simple method for intracorporeal circular-stapled esophagojejunostomy using a modified over-and-over suture technique. The surgical outcomes of our technique were evaluated in comparison with those of open total gastrectomy (OTG). METHODS: From April 2012 to August 2014, reconstruction using this method in LTG was performed for 21 consecutive patients with gastric cancer (LTG group). Their surgical outcomes were compared with those of 27 patients with gastric cancer who underwent OTG without splenectomy (OTG group) between January 2011 and April 2014. RESULTS: Estimated blood loss was significantly lower, and the postoperative hospital stay was significantly shorter in the LTG group than in the OTG group. The operating time and the number of harvested lymph nodes were similar between the two groups. The incidence of overall complications did not differ significantly between the two groups. Anastomotic leakage developed in one of the 21 patients in the LTG group and in two of the 27 patients in the OTG group. Anastomotic stenosis was observed in one patient in the LTG group. CONCLUSIONS: We consider this method as simple and feasible for most laparoscopic surgeons with basic laparoscopic suturing skills. This method might help LTG to become an accepted standard surgical option for treatment of patients with gastric cancer.
BACKGROUND: Esophagojejunostomy in laparoscopic total gastrectomy (LTG) is a technically demanding procedure. Although several methods have been reported to date, none is considered consistently reliable. We developed a simple method for intracorporeal circular-stapled esophagojejunostomy using a modified over-and-over suture technique. The surgical outcomes of our technique were evaluated in comparison with those of open total gastrectomy (OTG). METHODS: From April 2012 to August 2014, reconstruction using this method in LTG was performed for 21 consecutive patients with gastric cancer (LTG group). Their surgical outcomes were compared with those of 27 patients with gastric cancer who underwent OTG without splenectomy (OTG group) between January 2011 and April 2014. RESULTS: Estimated blood loss was significantly lower, and the postoperative hospital stay was significantly shorter in the LTG group than in the OTG group. The operating time and the number of harvested lymph nodes were similar between the two groups. The incidence of overall complications did not differ significantly between the two groups. Anastomotic leakage developed in one of the 21 patients in the LTG group and in two of the 27 patients in the OTG group. Anastomotic stenosis was observed in one patient in the LTG group. CONCLUSIONS: We consider this method as simple and feasible for most laparoscopic surgeons with basic laparoscopic suturing skills. This method might help LTG to become an accepted standard surgical option for treatment of patients with gastric cancer.
Authors: Cristiano G S Huscher; Andrea Mingoli; Giovanna Sgarzini; Gioia Brachini; Barbara Binda; Massimiliano Di Paola; Cecilia Ponzano Journal: Am J Surg Date: 2007-12 Impact factor: 2.565
Authors: Song Wang; Mei-Lan Su; Yang Liu; Zhi-Ping Huang; Ning Guo; Tian-Jin Chen; Zhong-Hui Zou Journal: World J Clin Cases Date: 2020-03-06 Impact factor: 1.337