AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV il^(TM). METHODS: After a total median phrenotomy, the supradiaphragmati...AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV il^(TM). METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV il^(TM)was inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min(range; 210-367 min), and median blood loss was 210 mL(range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3(range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d(range: 15-20 d). The median length of esophageal involvement was 14 mm(range: 6-48 mm) and that of the resected esophagus was 40 mm(range: 35-55 mm); all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.展开更多
文摘AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV il^(TM). METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV il^(TM)was inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min(range; 210-367 min), and median blood loss was 210 mL(range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3(range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d(range: 15-20 d). The median length of esophageal involvement was 14 mm(range: 6-48 mm) and that of the resected esophagus was 40 mm(range: 35-55 mm); all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.
