Totally laparoscopic total gastrectomy using the overlap method; early outcomes of 50 consecutive cases

Lee, Tae-Gyun; Kim, Beom Su; Yook, Jeong-Hwan; Kim, Byung-Sik

doi:10.1007/s00464-016-5343-6

Cited by 22 publications

(11 citation statements)

References 12 publications

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“…[15,16] Several studies have shown that the esophagojejunal anastomotic complication ranged from 0 to 6.45% in the functional method, [17,18] whereas few reports have illustrated the use of the overlap method. [19,20] In our perspective, modi ed π-shaped anastomosis, an alternative form of the functional method, has its own advantages theoretically. First, during the common entry hole closure, hand-sewing technique was usually practiced in overlap method, which may result not only in the increasing risk of anastomotic leakage and bleeding but also extend the learning curve.…”

Section: Discussionmentioning

confidence: 99%

Modified π-shaped Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: a Report of 40 Consecutive Cases From a Single Center

Jin¹,

Xu²,

Liu³

et al. 2021

Preprint

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Background: Intracorporeal esophagojejunostomy remains a challenging technique in totally laparoscopic total gastrectomy (TLTG) without established standard anastomosis method. π-shaped esophagojejunostomy in TLTG was reported to be safe and feasible. Therefore, this study aimed to depict our modified π-shaped esophagojejunostomy in TLTG and evaluate its short-term surgical outcomes.Methods: From April 2018 to October 2019, 40 patients with gastric cancer who underwent TLTG by the same surgeon with modified π-shaped esophagojejunostomy were enrolled. Clinicopathologic data including age, gender, body mass index, American Society of Anesthesiologists score, tumor size, tumor location, depth of tumor invasion, number of harvested lymph nodes, nodal metastasis and TNM stage, operative time, estimated blood loss, time to resume diet, postoperative hospital stays, complication, and mortality were collected and retrospectively analyzed.Results: The mean operative time and estimated blood loss were 264.6 ± 56.9 min and 68.5 ± 53.3 mL, respectively. Postoperative flatus occurred at 4.6 ± 1.7 days. The mean time to resume diet was 7.4 ± 1.7 days postoperatively. One patient was diagnosed with anastomotic leakage and managed with conservative therapy. Pleural effusion, occurring in 4 (10%) patients, was the most common complication. One patient experienced intra-abdominal bleeding requiring reoperation. Other complications were atrial fibrillation and wound infection. No mortality occurred during the 6-month follow-up.Conclusions: Modified π-shaped esophagojejunostomy is a safe and feasible method for intracorporeal anastomosis in TLTG, which showed favorable surgical outcomes.

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Section: Discussionmentioning

confidence: 99%

Modified π-shaped Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: a Report of 40 Consecutive Cases From a Single Center

Jin¹,

Xu²,

Liu³

et al. 2021

Preprint

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“…Studies (33,34) reported that the purse-string suture method was a safe and reliable technique. However, the long operation time, high operation difficulty and high price limit its application (35,36). However, intracorporeal hand-sewn esophagojejunostomy under visualization can not only ensure the tension at the anastomosis but also make the anastomosis more reliable.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Suspension Method for Hand-Sewn Esophagojejunostomy After Totally Laparoscopic Total Gastrectomy: A Simple, Safe, and Feasible Suturing Technique

et al. 2020

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Background: Totally laparoscopic total gastrectomy (TLTG) not only is difficult to operate but also has high technical requirements and a long learning curve. Therefore, it has not been widely carried out yet, and esophagojejunostomy is one of its difficulties. Relevant studies have shown that intracorporeal hand-sewn esophagojejunostomy is safe, feasible and low-cost, but it is complicated and time-consuming and requires a high-suture technique. This study introduces a simple, safe and feasible hand-sewn technique.Methods: The clinical data of 32 patients with the esophageal suspension method for hand-sewn esophagojejunostomy (suspension group) after TLTG were collected from February 2018 to June 2019. During the same period, 32 patients with traditional hand-sewn esophagojejunostomy (traditional group) after TLTG were used as the control group.Results: The operative time, anastomosis time, exhaust time and hospitalization time of the suspension group were shorter than those of the traditional group. The intraoperative blood loss in the suspension group was less than that in the traditional group. There were no postoperative complications associated with the suspension group.Conclusion: For those who have some experience in laparoscopic suture technique, the esophageal suspension method for hand-sewn esophagojejunostomy after TLTG is a simple, safe, and feasible suture technique.

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“…Ali et al [115] 2016 CS RPM 58 199.8 ± 57.0 81.6 ± 40. 3 5Wang et al [96] Duan et al [116] Lee et al [117] 2017 LS Overlap 50 144.6 ± 29.9 NA 0…”

Section: Conclusion and Prospectsmentioning

confidence: 99%

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

Shen¹,

Ma²,

Yang³

et al. 2019

WJGO

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Totally laparoscopic total gastrectomy using the overlap method; early outcomes of 50 consecutive cases

Abstract: We reported favorable surgical outcomes of TLTG using the overlap method. It is a feasible and safe option for treatment of gastric cancer.

Cited by 22 publications

References 12 publications

Modified π-shaped Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: a Report of 40 Consecutive Cases From a Single Center

Modified π-shaped Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: a Report of 40 Consecutive Cases From a Single Center

Esophageal Suspension Method for Hand-Sewn Esophagojejunostomy After Totally Laparoscopic Total Gastrectomy: A Simple, Safe, and Feasible Suturing Technique

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

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