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Published in: Surgical Endoscopy 11/2017

01-11-2017

Comparison of OrVil™ and RPD in laparoscopic total gastrectomy for gastric cancer

Authors: Xi Li, Liang Hong, Dan Ding, Yaping Liu, Gengming Niu, Liang Li, Xin Wang, Xiaomei Li, Chongwei Ke

Published in: Surgical Endoscopy | Issue 11/2017

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Abstract

Background

Laparoscopic total gastrectomy (LTG) is frequently performed for treating patients with gastric cancer; however, the absence of anastomotic techniques with greater superiority has impaired its popularization. We have compared two types of anastomotic techniques with regard to technical perspectives and clinical outcomes.

Methods

We reviewed 43 patients with gastric cancer who underwent LTG. Two types of anastomotic techniques have been applied after LTG—the trans-orally inserted anvil (OrVil™) and the reverse puncture device (RPD). Data on the type of anastomosis, blood loss, operation time, anastomosis time, location of tumors, distance between the top border of tumors and top resection margin, diameter of tumor, length of postoperative hospital stay, early and late postoperative complications, and total cost of surgical consumables were obtained by reviewing patient medical records and analyzed thereafter.

Results

We included 32 men and 11 women (mean age 61 years). The loss to follow-up rate was 13.2%. The median survival time for the OrVil™ and RPD groups was 23 and 22 months, respectively. The total rate of complications was 9.3%. The difference in the anastomosis times between the groups was statistically significant. OrVil™ required more time than RPD and cost more than RPD.

Conclusions

Both the OrVil™ and RPD techniques showed good safety and applicability in LTG. RPD showed an advantage with regard to lesser operative complexity and lower cost.
Literature
1.
go back to reference Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234CrossRefPubMed Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234CrossRefPubMed
2.
go back to reference Okabe H, Tsunoda S, Tanaka E, Hisamori S, Kawada H, Sakai Y (2015) Is laparoscopic total gastrectomy a safe operation? A review of various anastomotic techniques and their outcomes. Surg Today 45:549–558CrossRefPubMed Okabe H, Tsunoda S, Tanaka E, Hisamori S, Kawada H, Sakai Y (2015) Is laparoscopic total gastrectomy a safe operation? A review of various anastomotic techniques and their outcomes. Surg Today 45:549–558CrossRefPubMed
3.
go back to reference Shim JH, Yoo HM, Oh SI, Nam MJ, Jeon HM, Park CH, Song KY (2013) Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 16:420–427CrossRefPubMed Shim JH, Yoo HM, Oh SI, Nam MJ, Jeon HM, Park CH, Song KY (2013) Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 16:420–427CrossRefPubMed
4.
go back to reference Liao GQ, Ou XW, Liu SQ, Zhang SR, Huang W (2013) Laparoscopy-assisted total gastrectomy with trans-orally inserted anvil (OrVil): a single institution experience. World J Gastroenterol 19:755–760CrossRefPubMedPubMedCentral Liao GQ, Ou XW, Liu SQ, Zhang SR, Huang W (2013) Laparoscopy-assisted total gastrectomy with trans-orally inserted anvil (OrVil): a single institution experience. World J Gastroenterol 19:755–760CrossRefPubMedPubMedCentral
5.
go back to reference Chong-Wei K, Dan-Lei C, Dan D (2013) A modified technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy. Surg Laparosc Endosc Percutaneous Tech 23:e109–e115CrossRef Chong-Wei K, Dan-Lei C, Dan D (2013) A modified technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy. Surg Laparosc Endosc Percutaneous Tech 23:e109–e115CrossRef
6.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral
7.
go back to reference Association JGC (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef Association JGC (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef
8.
go back to reference Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed
9.
go back to reference Chen D, Cheng P, Ding D, Ke Z (2014) Feasibility and safety of a novel reverse puncture device (RPD) for laparoscopic esophagogastrostomy/esophagojejunostomy. Int J Clin Exp Med 7:2497–2503PubMedPubMedCentral Chen D, Cheng P, Ding D, Ke Z (2014) Feasibility and safety of a novel reverse puncture device (RPD) for laparoscopic esophagogastrostomy/esophagojejunostomy. Int J Clin Exp Med 7:2497–2503PubMedPubMedCentral
10.
go back to reference Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23:2624–2630CrossRefPubMed Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23:2624–2630CrossRefPubMed
11.
go back to reference Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, Park SM (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442CrossRefPubMed Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, Park SM (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442CrossRefPubMed
12.
go back to reference Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, Yano M, Monden M (2005) A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today 35:896–899CrossRefPubMed Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, Yano M, Monden M (2005) A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today 35:896–899CrossRefPubMed
13.
go back to reference Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11:233–237CrossRefPubMed Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11:233–237CrossRefPubMed
14.
go back to reference Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y (2009) Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 23:2167–2171CrossRefPubMed Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y (2009) Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 23:2167–2171CrossRefPubMed
15.
go back to reference Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, Uyama I (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211:e25–e29CrossRefPubMed Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, Uyama I (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211:e25–e29CrossRefPubMed
16.
go back to reference Kunisaki C, Makino H, Oshima T, Fujii S, Kimura J, Takagawa R, Kosaka T, Akiyama H, Morita S, Endo I (2011) Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy. Surg Endosc 25:1300–1305CrossRefPubMed Kunisaki C, Makino H, Oshima T, Fujii S, Kimura J, Takagawa R, Kosaka T, Akiyama H, Morita S, Endo I (2011) Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy. Surg Endosc 25:1300–1305CrossRefPubMed
17.
go back to reference Marangoni G, Villa F, Shamil E, Botha AJ (2012) OrVil-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon. Surg Endosc 26:811–817CrossRefPubMed Marangoni G, Villa F, Shamil E, Botha AJ (2012) OrVil-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon. Surg Endosc 26:811–817CrossRefPubMed
18.
go back to reference Xie JW, Huang CM, Zheng CH, Li P, Wang JB, Lin JX, Jun L (2013) A safe anastomotic technique of using the transorally inserted anvil (OrVil) in Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy for proximal malignant tumors of the stomach. World J Surg Oncol 11:256CrossRefPubMedPubMedCentral Xie JW, Huang CM, Zheng CH, Li P, Wang JB, Lin JX, Jun L (2013) A safe anastomotic technique of using the transorally inserted anvil (OrVil) in Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy for proximal malignant tumors of the stomach. World J Surg Oncol 11:256CrossRefPubMedPubMedCentral
19.
go back to reference LaFemina J, Vinuela EF, Schattner MA, Gerdes H, Strong VE (2013) Esophagojejunal reconstruction after total gastrectomy for gastric cancer using a transorally inserted anvil delivery system. Ann Surg Oncol 20:2975–2983CrossRefPubMed LaFemina J, Vinuela EF, Schattner MA, Gerdes H, Strong VE (2013) Esophagojejunal reconstruction after total gastrectomy for gastric cancer using a transorally inserted anvil delivery system. Ann Surg Oncol 20:2975–2983CrossRefPubMed
20.
go back to reference Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197:e13–e17CrossRefPubMed Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197:e13–e17CrossRefPubMed
21.
go back to reference Salih AE, Bass GA, D’Cruz Y, Brennan RP, Smolarek S, Arumugasamy M, Walsh TN (2015) Extending the reach of stapled anastomosis with a prepared OrVil device in laparoscopic oesophageal and gastric cancer surgery. Surg Endosc 29:961–971CrossRefPubMed Salih AE, Bass GA, D’Cruz Y, Brennan RP, Smolarek S, Arumugasamy M, Walsh TN (2015) Extending the reach of stapled anastomosis with a prepared OrVil device in laparoscopic oesophageal and gastric cancer surgery. Surg Endosc 29:961–971CrossRefPubMed
22.
Metadata
Title
Comparison of OrVil™ and RPD in laparoscopic total gastrectomy for gastric cancer
Authors
Xi Li
Liang Hong
Dan Ding
Yaping Liu
Gengming Niu
Liang Li
Xin Wang
Xiaomei Li
Chongwei Ke
Publication date
01-11-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5554-5

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