J Minim Invasive Surg.  2020 Mar;23(1):17-21. 10.7602/jmis.2020.23.1.17.

Left Dorsal Wall Anastomosis Compared with Parallel-Line Anastomosis for Intracorporeal Overlap Esophagojejunostomy during Laparoscopic Total Gastrectomy

• Lee JE
• Kim KH
• Seo KW

• KMID: 2502935
• DOI: http://doi.org/10.7602/jmis.2020.23.1.17

Abstract

Purpose
This study evaluated the safety and efficacy of totally laparoscopic total gastrectomy (TLTG) with esophagojejunostomy by comparing left dorsal wall anastomosis (LDA) with parallelline anastomosis (PA) methods.
Methods
We retrospectively reviewed 28 patients who underwent laparoscopic total gastrectomy (LTG) for gastric cancer from January 2017 to September 2018. The patients were divided into two groups according to type of operation: 15 patients underwent PA and 13 underwent LDA. Clinicopathologic characteristics and surgical outcomes in the two groups were compared and analyzed.
Results
Surgical outcomes of estimated blood loss, operation time, and length of postoperative stay were similar between the two groups. In addition, there was no statistical difference in total operation time (186.5±37.0 min vs. 209.0±36.9 min, p=0.121) between the two groups. However, compared with the PA group, the LDA group required fewer additional stitches for reinforcement (p=0.002).
Conclusion
Intracorporeal reconstruction of esophagojejunostomy using an LDA method may be a feasible and easy technique for TLTG compared with the PA method. Additional studies with larger sample sizes are needed to further support these results.

Keyword

Gastric neoplasms; Laparoscopy; Gastrectomy; Anastomosis