Modified Techniques and Early Outcomes of Totally Laparoscopic Total Gastrectomy with Side-to-Side Esophagojejunostomy

Kim, Beom Su; Kim, Tae‐Hwan; Kim, Kab-Choong; Yook, Jeong-Hwan; Kim, Byung-Sik

doi:10.1089/lap.2012.0177

Cited by 21 publications

(9 citation statements)

References 16 publications

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“…Steichen introduced a functional end-to-end anastomosis that has been adopted worldwide [16]. Matsui et al and Lee et al concluded that functional end-to-end esophagojejunostomy after a total gastrectomy is convenient, safe, reliable, and independent of the esophagus and depth of the esophageal hiatus [17, 18]. Functional end-to-end esophagojejunostomy after total gastrectomy in open surgery has become accepted, whereas laparoscopic esophagojejunostomy seems quite rare.…”

Section: Discussionmentioning

confidence: 99%

Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy

Ebihara

Okushiba

Kawarada

et al. 2013

Langenbecks Arch Surg

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PurposeTotally laparoscopic total gastrectomy (TLTG) is unpopular because reconstruction is difficult. In fact, esophagojejunostomy is the most difficult surgical technique in TLTG. We adopted functional end-to-end anastomosis for esophagojejunostomy to simplify the procedure. The present study assesses the feasibility and surgical outcomes of TLTG with functional end-to-end esophagojejunostomy.MethodsWe assessed the intraoperative and postoperative outcomes of 65 consecutive patients who underwent TLTG with functional end-to-end esophagojejunostomy at Tonan Hospital between January 2006 and August 2011.ResultsThe mean surgical duration was 271.5 ± 64.7 min, and the mean blood loss was 85.2 ± 143.2 g. One patient (1.5 %) was converted to open surgery, and two patients (3.1 %) required reoperation due to ileus because of an internal hernia and jejunojejunostomy leakage. No reoperation was associated with functional end-to-end esophagojejunostomy. The mean hospital stay was 21.4 ± 13.5 days. Ten patients (15.4 %) developed postoperative complications, of which three (4.6 %) were anastomotic stenosis associated with functional end-to-end esophagojejunostomy. All of these were resolved by endoscopic dilation.ConclusionFunctional end-to-end esophagojejunostomy in TLTG is safe and feasible.

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Section: Discussionmentioning

confidence: 99%

Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy

Ebihara

Okushiba

Kawarada

et al. 2013

Langenbecks Arch Surg

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“…Consequently, totally laparoscopic distal gastrectomy is increasingly employed and has a proven history of safety and feasibility[ 2 - 8 ]. However, although scholars have reported a variety of totally laparoscopic total gastrectomy (TLTG) methods[ 3 , 9 - 13 ], this technique has not been widely adopted because of the technological difficulty inherent in digestive reconstruction. Interest in improving the postoperative appearance and quality of life (QoL) in patients with gastric cancer has been increased.…”

Section: Introductionmentioning

confidence: 99%

Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life

Huang¹,

Huang²,

Zheng³

et al. 2017

WJG

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AIMTo evaluate the short-term outcomes and quality of life (QoL) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG).METHODSA total of 507 patients who underwent laparoscopic gastrectomy (D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG (group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy (LATG) (group A, n = 456). The short-term outcomes and QoL were compared between the two groups after 1:2 propensity-score matching (PSM). We used a questionnaire to assess QoL.RESULTSBefore matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups (P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A (P < 0.05). After matching, group T reported better QoL in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better QoL (“Have you felt pain” and “Have you had difficulty eating solid food”) (P < 0.05).CONCLUSIONThe IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving QoL after laparoscopic gastrectomy.

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“…These anastomosis techniques are less technically complex. They can effectively prevent the occurrence of anastomotic stenosis (23)(24)(25)(26). However, the closure of the joint opening with the Endo GIA makes the overlap procedure easier but tends to cause stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…4 ± 9 . 4 ( 2 6 -4 1 ) m i n , intraoperative bleeding was 141.2 ± 24.9 (130-160) mL, and the number of resected lymph nodes was 23 ± 8 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Patients who underwent hand-sewn esophagojejunostomy did not differ significantly from those who underwent conventional mechanical esophagojejunostomy ( Table 2).…”

Section: Surgery Detailsmentioning

confidence: 99%

Technical details of and prognosis for the "China stitch", a novel technique for totally laparoscopic hand-sewn esophagojejunostomy

Sun

Zheng

Chen

et al. 2020

BST

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Modified Techniques and Early Outcomes of Totally Laparoscopic Total Gastrectomy with Side-to-Side Esophagojejunostomy

Abstract: Our TLTG with side-to-side esophagojejunostomy method can be a feasible and safe option for patients with gastric cancer.

Cited by 21 publications

References 16 publications

Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy

Outcome of functional end-to-end esophagojejunostomy in totally laparoscopic total gastrectomy

Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life

Technical details of and prognosis for the "China stitch", a novel technique for totally laparoscopic hand-sewn esophagojejunostomy

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