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논문 기본 정보

자료유형
학술저널
저자정보
Moon-Won Yoo (Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Chang Seok Ko (Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) 정진호 (Department of Surgery Asan Medical Center University of Ulsan College of Medicine) In-Seob Lee (Department of Surgery University of Ulsan College of Medicine and Asan Medical Center Seoul Korea) Beom Su Kim (Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Min-Ju Kim (Department of Clinical Epidemiology and Biostatistics Asan Medical Center)
저널정보
대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제21권 제1호
발행연도
2021.1
수록면
63 - 73 (11page)

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Purpose: This study aimed to compare the surgical outcomes of total laparoscopic total gastrectomy without mesentery division (LTG without MD) and conventional total laparoscopic total gastrectomy (CLTG), as well as evaluate the appropriate method for esophagojejunostomy (EJ) reconstruction after total laparoscopic total gastrectomy (TLTG). Materials and Methods: We retrospectively analyzed data from 301 consecutive patients who underwent TLTG for upper or middle third gastric cancer between January 2016 and May 2019. After propensity score matching, 95 patients who underwent LTG without MD and 95 who underwent CLTG were assessed. Data on clinical characteristics and surgical outcomes, including operation time, length of postoperative hospital stay, pathological findings, and postoperative complications were analyzed. Results: The LTG without MD group showed a shorter time to first flatus (3.26±0.80 vs. 3.62±0.81 days, P=0.003) and a shorter time to soft diet (2.80±2.09 vs. 3.52±2.20 days, P=0.002). The total EJ-related complications in the LTG without MD group were comparable to those in the CLTG group (9.47% vs. 3.16%, P=0.083). EJ-related leakage (6.32% vs. 3.16%, P=0.317) and EJ-related stricture (3.16% vs. 1.05%, P=0.317) rates were not significantly different between the LTG without MD and CLTG groups. No significant differences were found between the two groups in terms of other early surgical outcomes such as early complications, late complications, hospital stay, and readmission rate. Conclusions: LTG without MD is a safe surgical treatment for upper or middle third gastric cancer. LTG without MD may be an alternative procedure for EJ anastomosis during TLTG.
#Laparoscopic surgery #Gastrectomy #Stomach neoplasms #Anastomosis

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참고문헌 (24)

참고문헌 신청
Chen K / 2017 / Totally laparoscopic versus open total gastrectomy for gastric cancer: a case-matched study about short-term outcomes / Medicine (Baltimore) 96:e8061 google schola Kim HS / 2013 / Comparison of totally laparoscopic total gastrectomy and open total gastrectomy for gastric cancer / J Laparoendosc Adv Surg Tech A 23:323~331 google schola Gong W / 2017 / Combat with esophagojejunal anastomotic leakage after total gastrectomy for gastric cancer : a critical review of the literature / Int J Surg 47:18~24 google schola Lee S / 2016 / Clinical outcomes of postoperative upper gastrointestinal leakage according to treatment modality / Dig Dis Sci 61:523~532 google schola Sierzega M / 2010 / Impact of anastomotic leakage on long-term survival after total gastrectomy for carcinoma of the stomach / Br J Surg 97:1035~1042 google schola

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