Ann Surg Treat Res.  2017 Jan;92(1):30-34. 10.4174/astr.2017.92.1.30.

Intracorporeal esophagojejunostomy using hemi-double-stapling technique after laparoscopic total gastrectomy in gastric cancer patients

• Ali B
• Park CH
• Song KY

• KMID: 2364711
• DOI: http://doi.org/10.4174/astr.2017.92.1.30

Abstract

PURPOSE
To present the feasibility and safety of Roux-en-Y esophagojejunostomy using hemi-double-stapling technique after laparoscopic total gastrectomy.
METHODS
We reviewed the outcomes from 58 consecutive patients with gastric cancer who underwent laparoscopic total gastrectomy. The clinicopathological characteristics including postoperative complications were examined.
RESULTS
The mean age and body mass index were 57.3 ± 9.7 years and 23.7 ± 2.6 kg/m², respectively. The mean overall total operation was 199.8 ± 57.0 minutes. Intraoperative blood loss was 81.6 ± 56.3 mL and there was no open conversion. The patients' hospital stay was a mean 9.6 ± 2 days. The mean proximal margin of the specimens was 2.7 ± 1.8 cm. There were 3 cases (5.1%) of anastomosis leakage, but all were controlled successfully by endoscopic stent.
CONCLUSION
The circular HDST technique is simple and reliable without any significant demerits with respect to safety concerns or difficulty of operation.

Keyword

Intracorporeal esophagojejunostomy; Hemi-double-stapling technique; Laparoscopic total gastrectomy; Gastric cancer; Feasibility

MeSH Terms

Body Mass Index
Gastrectomy*
Humans
Length of Stay
Postoperative Complications
Stents
Stomach Neoplasms*

Figure

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  Fig. 1 The prepared anvil of the circular stapler was inserted into the esophagus through the gastrotomy incision and then positioned in the thoracic esophagus.

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  Fig. 2 The distal esophagus was transected with a linear stapler.

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  Fig. 3 End-to-side esophagojejunal anastomosis was performed under laparoscopy.

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