Two-Layer Hand-Sewn Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy for Gastric Cancer

Enrique Norero; Rodrigo Muñoz; Marco Ceroni; Manuel Manzor; Fernando Crovari; Mauricio Gabrielli

doi:https://doi.org/10.5230/jgc.2017.17.e26

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자료유형: 학술저널

저자정보: Enrique Norero (Pontificia Universidad Católica de Chile) Rodrigo Muñoz (Pontificia Universidad Católica de Chile) Marco Ceroni (Pontificia Universidad Católica de Chile) Manuel Manzor (Pontificia Universidad Católica de Chile) Fernando Crovari (Pontificia Universidad Católica de Chile) Mauricio Gabrielli (Pontificia Universidad Católica de Chile)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제17권 제3호

발행연도: 2017.9

수록면: 267 - 276 (10page)

DOI: https://doi.org/10.5230/jgc.2017.17.e26

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Purpose: Different esophagojejunostomy (EJ) reconstruction methods are used after totally laparoscopic total gastrectomy (TLTG), and none is considered a standard technique. This report describes a 2-layer hand-sewn EJ technique during TLTG; we also evaluated postoperative morbidity associated with this technique. Materials and Methods: This retrospective cohort study included all consecutive patients who underwent TLTG for gastric cancer (GC) from 2012 to 2016 at 2 affiliated teaching hospitals. All participating surgeons performed standardized intracorporeal 2-layer hand-sewn EJ. Results: We included 51 patients who underwent TLTG for GC and standardized EJ anastomosis. Twenty-seven (53%) were male, and the median age was 60 (36?87) years. The average operative time was 337±71 minutes and intraoperative bleeding was 160±107 mL. There were no open conversions related to EJ. Postoperative morbidity was observed in 9 (17.0%) patients. There was no postoperative mortality. EJ leakage was observed in 2 patients (3.8%) and 1 patient (1.9%) developed EJ stenosis. Patients with leakage were managed non-operatively and the patient with stenosis required endoscopic dilation. The median length of hospital stay was 8 (6?29) days. Conclusions: Two-layer hand-sewn EJ during TLTG for GC is a feasible and safe technique. This method avoids a laparotomy for reconstruction and the disadvantages associated with laparoscopic introduction of mechanical staplers for EJ, and provides an alternative for alimentary tract reconstruction after TLTG.

#Gastrectomy #Stomach neoplasms #Laparoscopy #Esophagojejunostomy

참고문헌 (21)

참고문헌 신청

Kitano S / 1994 / Laparoscopy-assisted Billroth I gastrectomy / Surg Laparosc Endosc 4:146~148

LaFemina J / 2013 / Esophagojejunal reconstruction after total gastrectomy for gastric cancer using a transorally inserted anvil delivery system / Ann Surg Oncol 20:2975~2983

Moisan F / 2012 / Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer : a matched cohort study / Surg Endosc 26:661~672

Norero E / 2015 / Totally laparoscopic gastrectomy for the treatment of gastric tumors / Rev Med Chil 143:281~288

Japanese Gastric Cancer Association / 2011 / Japanese gastric cancer treatment guidelines 2010 (ver. 3) / Gastric Cancer 14:113~123

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