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01-11-2015 | Dynamic Manuscript

Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy

Authors: Takeru Matsuda, Takeshi Iwasaki, Masaaki Mitsutsuji, Kenro Hirata, Yoko Maekawa, Daisuke Tsugawa, Yutaka Sugita, Etsuji Shimada, Yoshihiro Kakeji

Published in: Surgical Endoscopy | Issue 11/2015

Abstract

Background

Esophagojejunostomy in laparoscopic total gastrectomy (LTG) is a technically demanding procedure. Although several methods have been reported to date, none is considered consistently reliable. We developed a simple method for intracorporeal circular-stapled esophagojejunostomy using a modified over-and-over suture technique. The surgical outcomes of our technique were evaluated in comparison with those of open total gastrectomy (OTG).

Methods

From April 2012 to August 2014, reconstruction using this method in LTG was performed for 21 consecutive patients with gastric cancer (LTG group). Their surgical outcomes were compared with those of 27 patients with gastric cancer who underwent OTG without splenectomy (OTG group) between January 2011 and April 2014.

Results

Estimated blood loss was significantly lower, and the postoperative hospital stay was significantly shorter in the LTG group than in the OTG group. The operating time and the number of harvested lymph nodes were similar between the two groups. The incidence of overall complications did not differ significantly between the two groups. Anastomotic leakage developed in one of the 21 patients in the LTG group and in two of the 27 patients in the OTG group. Anastomotic stenosis was observed in one patient in the LTG group.

Conclusions

We consider this method as simple and feasible for most laparoscopic surgeons with basic laparoscopic suturing skills. This method might help LTG to become an accepted standard surgical option for treatment of patients with gastric cancer.

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Title: Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy
Authors: Takeru Matsuda
Takeshi Iwasaki
Masaaki Mitsutsuji
Kenro Hirata
Yoko Maekawa
Daisuke Tsugawa
Yutaka Sugita
Etsuji Shimada
Yoshihiro Kakeji
Publication date: 01-11-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4073-5

At a glance: The STEP trials

Springer Medicine

Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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