摘要
AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy(LTG).METHODS:Between July 2010 and December 2012,58 consecutive patients with early gastric cancer underwent LTG were enrolled.We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients.Then patients’characteristics,perioperative outcome and histopathologic data were analyzed retrospectively.RESULTS:The mean age and body mass index were59.3±9.7 years and 22.7±2.6 kg/m2.The mean operation,reconstruction and anvil insertion times(from gastric incision to linear stapling)were 251.8±57.0,43.1±2.8 and 4.2±1.9 min,respectively.Intraoperative blood loss was 204.6±156.3 m L and there was no open conversion.The postoperative complications were in 8 cases(delayed gastric emptying in 4 cases,pulmonary complication in 2cases,pancreatitis in 1 case,anastomotic stricture in 1case).Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention.The patients were discharged at a mean of 9.6±2.0 d after surgery.Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively.The mean proximal margin of specimen was 2.7±2.8 cm CONCLUSION:Roux-en Y esophagojejunostomy usingthe double stapling technique is simple and rapid,and it may offer a solid,alternative reconstruction method for LTG or proximal gastrectomy.
AIM:To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy(LTG).METHODS:Between July 2010 and December 2012,58 consecutive patients with early gastric cancer underwent LTG were enrolled.We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients.Then patients’characteristics,perioperative outcome and histopathologic data were analyzed retrospectively.RESULTS:The mean age and body mass index were59.3±9.7 years and 22.7±2.6 kg/m2.The mean operation,reconstruction and anvil insertion times(from gastric incision to linear stapling)were 251.8±57.0,43.1±2.8 and 4.2±1.9 min,respectively.Intraoperative blood loss was 204.6±156.3 m L and there was no open conversion.The postoperative complications were in 8 cases(delayed gastric emptying in 4 cases,pulmonary complication in 2cases,pancreatitis in 1 case,anastomotic stricture in 1case).Anastomotic stricture occurred after discharge and was recovered by endoscopic intervention.The patients were discharged at a mean of 9.6±2.0 d after surgery.Neither leakage nor bleeding from the esophagojejunostomy occurred postoperatively.The mean proximal margin of specimen was 2.7±2.8 cm CONCLUSION:Roux-en Y esophagojejunostomy usingthe double stapling technique is simple and rapid,and it may offer a solid,alternative reconstruction method for LTG or proximal gastrectomy.
基金
Supported by Pusan National University
the National R&D Program for Cancer Control at the Ministry for Health,Welfare and Family Affairs,South Korea,No.0920050
