AIM: To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy(LTG) for gastric cancer.METHODS: A retrospective review of 81 consecutive patients who...AIM: To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy(LTG) for gastric cancer.METHODS: A retrospective review of 81 consecutive patients who underwent LTG with the same surgical team between November 2007 and July 2014 was performed. Four types of intracorporeal esophagojejunostomy using staplers or hand-sewn suturing were performed after LTG. Data on clinicopatholgoical characteristics, occurrence of complications, postoperative recovery, anastomotic time, and operation time among the surgical groups were obtained through medical records.RESULTS: The average operation time was 288.7 min, the average anastomotic time was 54.3 min, and the average estimated blood loss was 82.7 m L. There were no cases of conversion to open surgery. The first flatus was observed around 3.7 d, while the liquid diet was started, on average, from 4.9 d. The average postoperative hospital stay was 10.1 d. Postoperative complications occurred in 14 patients, nearly 17.3%.However, there were no cases of postoperative death.CONCLUSION: LTG performed with intracorporeal esophagojejunostomy using laparoscopic staplers or hand-sewn suturing is feasible and safe. The surgical results were acceptable from the perspective of minimal invasiveness.展开更多
AIM:To systematically review the surgical outcomes of totally laparoscopic gastrectomy(TLG)vs open gastrectomy(OG)for gastric cancer.METHODS:A systematic search of PubMed,Embase,Cochrane Library,and Web of Science was...AIM:To systematically review the surgical outcomes of totally laparoscopic gastrectomy(TLG)vs open gastrectomy(OG)for gastric cancer.METHODS:A systematic search of PubMed,Embase,Cochrane Library,and Web of Science was conducted.All original studies comparing TLG with OG were included for critical appraisal.Data synthesis and statistical analysis were carried out using RevMan 5.1 software.RESULTS:One RCT and 13 observational studies involving 1532 patients were included(721 TLG and811 OG).TLG was associated with longer operation time[weighted mean difference(WMD)=58.04min,95%CI:37.77-78.32,P<0.001],less blood loss[WMD=-167.57 min,95%CI:-208.79-(-126.34),P<0.001],shorter hospital stay[WMD=-3.75 d,95%CI:-4.88-(-2.63),P<0.001]and fewer postoperative complications(RR=0.71,95%CI:0.58-0.86,P<0.001).The number of harvested lymph nodes,surgical margin,mortality and cancer recurrence rate were similar between the two groups.CONCLUSION:TLG may be a technically safe,feasible and favorable approach in terms of better cosmesis,less blood loss and faster recovery compared with OG.展开更多
基金Supported by Natural Science Foundation of Zhejiang Province,No.LY12H16026Chinese Medical Technology Foundation of Zhejiang Province,China,No.2012ZA087
文摘AIM: To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy(LTG) for gastric cancer.METHODS: A retrospective review of 81 consecutive patients who underwent LTG with the same surgical team between November 2007 and July 2014 was performed. Four types of intracorporeal esophagojejunostomy using staplers or hand-sewn suturing were performed after LTG. Data on clinicopatholgoical characteristics, occurrence of complications, postoperative recovery, anastomotic time, and operation time among the surgical groups were obtained through medical records.RESULTS: The average operation time was 288.7 min, the average anastomotic time was 54.3 min, and the average estimated blood loss was 82.7 m L. There were no cases of conversion to open surgery. The first flatus was observed around 3.7 d, while the liquid diet was started, on average, from 4.9 d. The average postoperative hospital stay was 10.1 d. Postoperative complications occurred in 14 patients, nearly 17.3%.However, there were no cases of postoperative death.CONCLUSION: LTG performed with intracorporeal esophagojejunostomy using laparoscopic staplers or hand-sewn suturing is feasible and safe. The surgical results were acceptable from the perspective of minimal invasiveness.
基金Supported by Zhejiang Key Subject of Medical Science Foun-dation,grant No.11-CX-21
文摘AIM:To systematically review the surgical outcomes of totally laparoscopic gastrectomy(TLG)vs open gastrectomy(OG)for gastric cancer.METHODS:A systematic search of PubMed,Embase,Cochrane Library,and Web of Science was conducted.All original studies comparing TLG with OG were included for critical appraisal.Data synthesis and statistical analysis were carried out using RevMan 5.1 software.RESULTS:One RCT and 13 observational studies involving 1532 patients were included(721 TLG and811 OG).TLG was associated with longer operation time[weighted mean difference(WMD)=58.04min,95%CI:37.77-78.32,P<0.001],less blood loss[WMD=-167.57 min,95%CI:-208.79-(-126.34),P<0.001],shorter hospital stay[WMD=-3.75 d,95%CI:-4.88-(-2.63),P<0.001]and fewer postoperative complications(RR=0.71,95%CI:0.58-0.86,P<0.001).The number of harvested lymph nodes,surgical margin,mortality and cancer recurrence rate were similar between the two groups.CONCLUSION:TLG may be a technically safe,feasible and favorable approach in terms of better cosmesis,less blood loss and faster recovery compared with OG.
