Top

Published in:

01-06-2012 | How-I-Do-It Article

Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy

Authors: Hironori Tsujimoto, Ichiro Uyama, Yoshihisa Yaguchi, Isao Kumano, Risa Takahata, Yusuke Matsumoto, Kazumichi Yoshida, Hiroyuki Horiguchi, Suefumi Aosasa, Satoshi Ono, Junji Yamamoto, Kazuo Hase

Published in: Langenbeck's Archives of Surgery | Issue 5/2012

Abstract

Background

Recently, novel intracorporeal esophagojejunostomy using a linear stapler after laparoscopic total gastrectomy (LTG) was reported and termed as the overlap method. In this study, we evaluated the feasibility and safety of the overlap method for esophagojejunostomy or esophagogastrostomy after LTG or laparoscopic proximal gastrectomy (LPG), respectively.

Methods

Twenty-five patients underwent anastomosis using a linear stapler during esophagojejunostomy and esophagogastrostomy after LTG and LPG, respectively. Clinicopathological data and surgical outcomes were evaluated.

Results

The average surgical duration for LTG was 236.8 min compared with 224.1 min for LPG. Postoperative complications were observed in four patients (16.0%); these included a wound infection, an intestinal obstruction, an afferent loop syndrome, and a reflux symptom. The average postoperative hospital stay of the patients was 12.5 days. There was no case of conversion to open surgery, anastomotic leakage or stenosis, or mortality.

Conclusions

The overlap method for esophagojejunostomy or esophagogastrostomy after LTG or LPG is safe and feasible and does not require an additional minilaparotomy, which may result in less pain and favorable cosmetic outcomes.

Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted billroth I gastrectomy. Surg Laparosc Endosc 4(2):146–148PubMed

10th nationwide survey of endoscopic surgery in Japan (2010). J Jpn Soc Endosc Surg 15 (5):565-679

Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23(11):2624–2630. doi:10.1007/s00464-009-0461-z PubMedCrossRef

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(1):e13–17. doi:10.1016/j.amjsurg.2008.04.019 PubMedCrossRef

Kim YW, Han HS, Fleischer GD (2003) Hand-assisted laparoscopic total gastrectomy. Surg Laparosc Endosc Percutan Tech 13(1):26–30PubMedCrossRef

Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Endosc 16(3):540–544. doi:10.1007/s00464-001-8219-2 PubMedCrossRef

Hiki N, Kaminishi M (2005) Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches. Langenbecks Arch Surg 390(5):442–447. doi:10.1007/s00423-005-0573-4 PubMedCrossRef

Meyer L, Meyer F, Dralle H, Ernst M, Lippert H, Gastinger I (2005) Insufficiency risk of esophagojejunal anastomosis after total abdominal gastrectomy for gastric carcinoma. Langenbecks Arch Surg 390(6):510–516. doi:10.1007/s00423-005-0575-2 PubMedCrossRef

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(6):e25–29. doi:S1072-7515(10)01072-0 PubMedCrossRef

10.

Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer 1(1):10–24. doi:10.1007/s101209800016 PubMedCrossRef

11.

Tsujimoto H, Sugasawa H, Ono S, Ichikura T, Yamamoto J, Hase K (2010) Has the accuracy of preoperative diagnosis improved in cases of early-stage gastric cancer? World J Surg 34(8):1840–1846. doi:10.1007/s00268-010-0587-0 PubMedCrossRef

12.

Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5(1):1–5PubMedCrossRef

13.

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(4):230–234. doi:10.1007/s101209900041 PubMedCrossRef

14.

Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, Hirai K, Watanabe M (2009) Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg 209(3):344–351. doi:S1072-7515(09)00410-4 PubMedCrossRef

15.

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(9):2167–2171. doi:10.1007/s00464-008-9987-8 PubMedCrossRef

16.

Okabe H, Satoh S, Inoue H, Kondo M, Kawamura J, Nomura A, Nagayama S, Hasegawa S, Itami A, Watanabe G, Sakai Y (2007) Esophagojejunostomy through minilaparotomy after laparoscopic total gastrectomy. Gastric Cancer 10(3):176–180. doi:10.1007/s10120-007-0432-9 PubMedCrossRef

17.

Ziqiang W, ZhiMin C, Jun C, Xiao L, Huaxing L, PeiWu Y (2008) A modified method of laparoscopic side-to-side esophagojejunal anastomosis: report of 14 cases. Surg Endosc 22(9):2091–2094. doi:10.1007/s00464-008-9744-z PubMedCrossRef

18.

Bracale U, Marzano E, Nastro P, Barone M, Cuccurullo D, Cutini G, Corcione F, Pignata G (2010) Side-to-side esophagojejunostomy during totally laparoscopic total gastrectomy for malignant disease: a multicenter study. Surg Endosc 24(10):2475–2479. doi:10.1007/s00464-010-0988-z PubMedCrossRef

19.

Kinoshita T, Oshiro T, Ito K, Shibasaki H, Okazumi S, Katoh R (2010) Intracorporeal circular-stapled esophagojejunostomy using hand-sewn purse-string suture after laparoscopic total gastrectomy. Surg Endosc 24(11):2908–2912. doi:10.1007/s00464-010-1041-y PubMedCrossRef

20.

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(4):233–237. doi:10.1007/s10120-008-0481-8 PubMedCrossRef

21.

Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, Seto Y, Muto T (2007) Laparoscopic esophagogastric circular stapled anastomosis: a modified technique to protect the esophagus. Gastric Cancer 10(3):181–186. doi:10.1007/s10120-007-0433-8 PubMedCrossRef

22.

Lee SE, Ryu KW, Nam BH, Lee JH, Kim YW, Yu JS, Cho SJ, Lee JY, Kim CG, Choi IJ, Kook MC, Park SR, Kim MJ, Lee JS (2009) Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy. J Surg Oncol 100(5):392–395. doi:10.1002/jso.21345 PubMedCrossRef

23.

Tonouchi H, Mohri Y, Tanaka K, Kobayashi M, Kusunoki M (2006) Hemidouble stapling for esophagogastrostomy during laparoscopically assisted proximal gastrectomy. Surg Laparosc Endosc Percutan Tech 16(4):242–244. doi:00129689-200608000-00009[pii] PubMedCrossRef

24.

Usui S, Inoue H, Yoshida T, Fukami N, Kudo SE, Iwai T (2003) Hand-assisted laparoscopic total gastrectomy for early gastric cancer. Surg Laparosc Endosc Percutan Tech 13(5):304–307PubMedCrossRef

25.

Hao YX, Zhong H, Yu PW, Qian F, Zhao YL, Shi Y, Tang B (2010) Influence of laparoscopic gastrectomy on the detection rate of free gastric cancer cells in the peritoneal cavity. Ann Surg Oncol 17(1):65–72. doi:10.1245/s10434-009-0703-2 PubMedCrossRef

Title: Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy
Authors: Hironori Tsujimoto
Ichiro Uyama
Yoshihisa Yaguchi
Isao Kumano
Risa Takahata
Yusuke Matsumoto
Kazumichi Yoshida
Hiroyuki Horiguchi
Suefumi Aosasa
Satoshi Ono
Junji Yamamoto
Kazuo Hase
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2012
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-012-0939-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2012

Randomized clinical trial on preoperative radiotherapy 25 Gy in rectal cancer—treatment results at 5-year follow-up

Estimate or calculate? How surgeons rate volumes and surfaces

Non-curative gastric resection for patients with stage 4 gastric cancer—a single center experience and current review of literature

Diagnostic study and meta-analysis of C-reactive protein as a predictor of postoperative inflammatory complications after gastroesophageal cancer surgery

Prognostic factors in differentiated thyroid cancer—a 20-year surgical outcome study

The safety of energy-based devices in open thyroidectomy: a prospective, randomised study comparing the LigaSure™ (LF1212) and the Harmonic® FOCUS