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

Sun, Zhipeng; Zheng, Xiaowan; Chen, Guanyang; Wang, Liang; Sang, Qing; Xu, Guangzhong; Zhang, Nengwei; Aminbuhe,

doi:10.5582/bst.2019.01329

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…The literature shows that the application of barbed thread in laparoscopic surgery and robotic surgery can significantly shorten the suture time under the laparoscope [11,[24][25][26][27][28][29]. The relevant experience necessary for performing hand-sewn esophageal jejunostomy and the suture technique has been extensively discussed in the literature [15,22,23,30,31]. The research experience of the team revealed the following: (1) The posterior wall of the anastomotic stoma was sutured continuously with barbed sutures, and the entire posterior wall was sutured intermittently with varus sutures; the anterior wall of the anastomotic site was first sutured with interrupted eversion; then, the seromuscular layer was continuously sutured with barbed sutures.…”

Section: Discussionmentioning

confidence: 99%

“…Although hand-sewn anastomosis has more requirements for the operation and a relative longer anastomosis time, its advantages include a good surgical field of view, operation in a narrow space, avoiding excessive traction, and ease in obtaining the pathology of the esophageal cutting edge before anastomosis. Notably, hand-sewn anastomosis has been reported to be a safe and feasible procedure [6][7][8][9][13][14][15], although clinical research remains insufficient. Therefore, we recorded the number of patients who underwent TLTG with hand-sewn anastomosis and with overlap anastomosis from January 2017 to January 2020.…”

Section: Introductionmentioning

confidence: 99%

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Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer

et al. 2021

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Background Digestive tract reconstruction in totally laparoscopic total gastrectomy can be divided into two types: instrument anastomosis and hand-sewn anastomosis. This study explored the feasibility and safety of hand-sewn sutures in esophagojejunostomy of totally laparoscopic total gastrectomy, compared with instrument anastomosis using an overlap linear cutter. Methods This retrospective cohort study was conducted from January 2017 to January 2020 at one institution. The clinical data of 50 patients who underwent totally laparoscopic total gastrectomy, with an average follow-up time of 12 months, were collected. The clinicopathologic data, short-term survival prognosis, and results of patients in the hand-sewn anastomosis (n=20) and the overlap anastomosis (n=30) groups were analyzed. Results There were no significant differences between the groups in sex, age, body mass index, American Society of Anesthesiologists score, tumor location, preoperative complications, abdominal operation history, tumor size, pTNM stage, blood loss, first postoperative liquid diet, exhaust time, or postoperative length of hospital stay. The hand-sewn anastomosis group had a significantly prolonged operation time (204±26.72min versus 190±20.90min, p=0.04) and anastomosis time (58±22.0min versus 46±15.97min, p=0.029), and a decreased operation cost (CNY 77,100±1700 versus CNY 71,900±1300, p<0.0001). Postoperative complications (dynamic ileus, abdominal infection, and pancreatic leakage) occurred in three patients (15%) in the hand-sewn anastomosis group and in four patients (13.3%) in the overlap anastomosis group (anastomotic leakage, anastomotic bleeding, dynamic ileus, and duodenal stump leakage). Conclusion The hand-sewn anastomosis method of esophagojejunostomy under totally laparoscopic total gastrectomy is safe and feasible and is an important supplement to linear and circular stapler anastomosis. It may be more convenient regarding obesity, a relatively high position of the anastomosis, edema of the esophageal wall, and short jejunal mesentery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer

et al. 2021

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“…However, advantages associated with this method, including a tension-free suture process, good blood supply, and a convenient cutting edge. Under the premise of skilled technology, it is also a surgical method in line with the concept of laparoscopy (12)(13)(14). This study retrospectively analyzed the intraoperative and postoperative results and related complications of intracorporeal overlap and intracorporeal hand-sewn anastomosis, and compared with LATG, which is widely used in clinical practice, to explore the advantages of two kinds of intracorporeal anastomosis and summarize the indications.…”

Section: Introductionmentioning

confidence: 99%

Digestive tract reconstruction of laparoscopic total gastrectomy for gastric cancer: a comparison of the intracorporeal overlap, intracorporeal hand-sewn anastomosis, and extracorporeal anastomosis

Wang¹,

Liu²,

Cheng³

et al. 2021

J Gastrointest Oncol

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Background: The application of esophagojejunostomy has certain difficulties in totally laparoscopic total gastrectomy (TLTG). This is due to the higher requirement for surgical techniques and the lack of any unified standards. This study aim to explore the practicability and safety of intracorporeal overlap and intracorporeal hand-sewn anastomosis compared with extracorporeal anastomosis. Methods:The clinical pathological data of 56 patients who underwent TLTG from March 2016 to Decemeber 2020 in the Harbin Medical University Cancer Hospital were retrospectively analyzed. According to the method of anastomosis, the patients were divided into the overlap (n=36) and the hand-sewn anastomosis (n=20). Patients who receive laparoscopic-assisted total gastrectomy (LATG; n=74) formed the control group.The basic clinical data, and intraoperative and postoperative results of the patients were assessed.Results: Compared with the control group, the overlap anastomosis and hand-sewn anastomosis groups showed no significant differences in clinicopathological data and short-term postoperative recovery. There were no significant differences between the overlap and the control group in operation time nor anastomosis time. However, the anastomosis time of the hand-sewn anastomosis group was significantly prolonged compared to the control group (53.20±14.14 vs. 43.01±12.53 minutes, P=0.002). Compared with the control group, the operation cost was significantly higher in the overlap group (CNY 81,300±6,100 vs. CNY 76,600±6,800, P=0.001), but significantly lower in the hand-sewn anastomosis group (CNY 71,900±1,700 vs. CNY 76,600±6,800, P=0.003). Early postoperative complications occurred in 5 cases (13.9%) in the overlap group, 3 cases (15.0%) in the hand-sewn anastomosis group, and 11 cases (14.9%) in the control group. There were 3 cases (8.3%) of postoperative anastomotic-related complications in the overlap group. No anastomotic-related complications were observed in the hand-sewn anastomosis group. Conclusions:The overlap anastomosis and hand-sewn anastomosis are practical and safe. Furthermore, the overlap anastomosis may be more suitable for patients with lower cardia and fundic lesions. The hand-sewn method has a wider range of indications pending advanced surgical skills, and is an effective supplementary technique for instrument anastomosis.

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Hand-sewn esophagojejunostomy in transthoracic single-port assisted laparoscopic esophagogastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction with esophageal invasion > 3 cm

et al. 2023

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

Cited by 5 publications

References 26 publications

Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer

Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer

Digestive tract reconstruction of laparoscopic total gastrectomy for gastric cancer: a comparison of the intracorporeal overlap, intracorporeal hand-sewn anastomosis, and extracorporeal anastomosis

Hand-sewn esophagojejunostomy in transthoracic single-port assisted laparoscopic esophagogastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction with esophageal invasion > 3 cm

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