Early outcomes of laparoscopic total gastrectomy with hemi-double stapling technique in gastric cancer

Abstract

Introduction: The most difficult step of laparoscopic total gastrectomy for gastric cancer is esophagojejunostomy anastomosis. Although various techniques are recommended for this anastomosis, there is no standard method. This study aims to present the outcomes of our patients who underwent esophagojejunostomy using the hemi-double stapling technique (HDST). Materials and Methods: Patients who had laparoscopic surgery due to gastric cancer in our hospital between October 2016 and May 2019 were retrospectively analyzed. Patients who underwent laparoscopic total gastrectomy with HDST were included in this study. The patients' clinical characteristics and histopathological data were evaluated. Age, sex, body mass index (BMI), comorbidities, and American Society of Anesthesiologists (ASA) scores were documented. Operative time, intraoperative blood loss, specimen extraction site, day of oral intake, length of stay, postoperative complications, and mortality were evaluated. Results: A total of 13 patients (eight male, five female) were included in this study. The mean age was 63.3±15.8 years, and mean BMI was 26.4±6.8 kg/m 2. ASA score was ASA III in seven patients (54%), ASA II in three patients (23%), and ASA I in the remaining three patients (23%). Mean operative time was 222.7±39.6 minutes, and mean intraoperative blood loss was 97.3±52.4 mL. There were no complications related to esophagojejunostomy. A mean of 23.8±11.1 lymph nodes was removed, of which a mean of 10.8±11.9 were tumor-positive. Mean length of stay was 10.9±9.8 days, and mean follow-up was 10.1±7 months. Conclusion: HDST appears to be a safe method that can be used in the esophagojejunostomy step of laparoscopic total gastrectomy for gastric cancer.