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Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes

Authors: Ke Chen, Di Wu, Yu Pan, Jia-Qin Cai, Jia-Fei Yan, Ding-Wei Chen, Hendi Maher, Yi-Ping Mou

Published in: World Journal of Surgical Oncology | Issue 1/2016

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Abstract

Background

Totally laparoscopic gastrectomy (TLG) using intracorporeal anastomosis has gradually become mature thanks to the advancements of laparoscopic surgical instruments and the accumulation of operative experience. The goal of this study is to review our institution’s experience with TLG for the treatment of gastric cancer.

Methods

A retrospective study was conducted to examine the short-term outcomes of TLG using intracorporeally stapler or hand-sewn anastomosis performed at Sir Run Run Shaw Hospital between March 2007 and June 2015. The details of intracorporeal anastomosis were described, and the clinicopathological data, surgical outcomes, and postoperative complications were evaluated.

Results

Four hundred seventy-eight patients were included in the study. Generally speaking, the patients could be divided into stapler or hand-sewn groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 97) or only stapling devices (n = 381). For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively. Postoperative complications were observed in 65 patients. All of the patients recovered well without perioperative death by conservative or surgical management.

Conclusions

TLG using intracorporeally stapler or hand-sewn anastomosis is a reasonable option for the treatment of gastric cancer, with early data showing acceptable perioperative outcomes.
Literature
1.
go back to reference Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146.PubMed Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146.PubMed
2.
go back to reference Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg. 2010;251:417.CrossRefPubMed Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg. 2010;251:417.CrossRefPubMed
3.
go back to reference Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008;248:721.CrossRefPubMed Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008;248:721.CrossRefPubMed
4.
go back to reference Chen K, Xu XW, Zhang RC, Pan Y, Wu D, Mou YP. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer. World J Gastroenterol. 2013;19:5365.CrossRefPubMedPubMedCentral Chen K, Xu XW, Zhang RC, Pan Y, Wu D, Mou YP. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer. World J Gastroenterol. 2013;19:5365.CrossRefPubMedPubMedCentral
5.
go back to reference Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, et al. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009;23:2374.CrossRefPubMed Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, et al. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009;23:2374.CrossRefPubMed
6.
go back to reference Kim BS, Yook JH, Choi YB, Kim KC, Kim MG, Kim TH, et al. Comparison of early outcomes of intracorporeal and extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer. J Laparoendosc Adv Surg Tech A. 2011;21:387.CrossRefPubMed Kim BS, Yook JH, Choi YB, Kim KC, Kim MG, Kim TH, et al. Comparison of early outcomes of intracorporeal and extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer. J Laparoendosc Adv Surg Tech A. 2011;21:387.CrossRefPubMed
7.
go back to reference Lee SW, Tanigawa N, Nomura E, Tokuhara T, Kawai M, Yokoyama K, et al. Benefits of intracorporeal gastrointestinal anastomosis following laparoscopic distal gastrectomy. World J Surg Oncol. 2012;12:267.CrossRef Lee SW, Tanigawa N, Nomura E, Tokuhara T, Kawai M, Yokoyama K, et al. Benefits of intracorporeal gastrointestinal anastomosis following laparoscopic distal gastrectomy. World J Surg Oncol. 2012;12:267.CrossRef
8.
go back to reference Chen K, Xu X, Mou Y, Pan Y, Zhang R, Zhou Y, et al. Totally laparoscopic distal gastrectomy with D2 lymphadenectomy and Billroth II gastrojejunostomy for gastric cancer: short- and medium-term results of 139 consecutive cases from a single institution. Int J Med Sci. 2013;10:1462.CrossRefPubMedPubMedCentral Chen K, Xu X, Mou Y, Pan Y, Zhang R, Zhou Y, et al. Totally laparoscopic distal gastrectomy with D2 lymphadenectomy and Billroth II gastrojejunostomy for gastric cancer: short- and medium-term results of 139 consecutive cases from a single institution. Int J Med Sci. 2013;10:1462.CrossRefPubMedPubMedCentral
9.
go back to reference Chen K, Mou YP, Xu XW, Pan Y, Zhou YC, Cai JQ, et al. Comparison of short-term surgical outcomes between totally laparoscopic and laparoscopic-assisted distal gastrectomy for gastric cancer: a 10-y single-center experience with meta-analysis. J Surg Res. 2015;194:367.CrossRefPubMed Chen K, Mou YP, Xu XW, Pan Y, Zhou YC, Cai JQ, et al. Comparison of short-term surgical outcomes between totally laparoscopic and laparoscopic-assisted distal gastrectomy for gastric cancer: a 10-y single-center experience with meta-analysis. J Surg Res. 2015;194:367.CrossRefPubMed
10.
go back to reference Chen K, Mou YP, Xu XW, Cai JQ, Wu D, Pan Y, et al. Short-term surgical and long-term survival outcomes after laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer. BMC Gastroenterol. 2014;14:41.CrossRefPubMedPubMedCentral Chen K, Mou YP, Xu XW, Cai JQ, Wu D, Pan Y, et al. Short-term surgical and long-term survival outcomes after laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer. BMC Gastroenterol. 2014;14:41.CrossRefPubMedPubMedCentral
11.
go back to reference Yan JF, Xu XW, Jin WW, Huang CJ, Chen K, Zhang RC, et al. Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: a retrospective study. World J Gastroenterol. 2014;20:13966.CrossRefPubMedPubMedCentral Yan JF, Xu XW, Jin WW, Huang CJ, Chen K, Zhang RC, et al. Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: a retrospective study. World J Gastroenterol. 2014;20:13966.CrossRefPubMedPubMedCentral
12.
go back to reference Etoh T, Inomata M, Shiraishi N, Kitano S. Minimally invasive approaches for gastric cancer—Japanese experiences. J Surg Oncol. 2013;107:282.CrossRefPubMed Etoh T, Inomata M, Shiraishi N, Kitano S. Minimally invasive approaches for gastric cancer—Japanese experiences. J Surg Oncol. 2013;107:282.CrossRefPubMed
13.
go back to reference Lee HW, Kim HI, An JY, Cheong JH, Lee KY, Hyung WJ, et al. Intracorporeal anastomosis using linear stapler in laparoscopic distal gastrectomy: comparison between gastroduodenostomy and gastrojejunostomy. J Gastric Cancer. 2011;11:212.CrossRefPubMedPubMedCentral Lee HW, Kim HI, An JY, Cheong JH, Lee KY, Hyung WJ, et al. Intracorporeal anastomosis using linear stapler in laparoscopic distal gastrectomy: comparison between gastroduodenostomy and gastrojejunostomy. J Gastric Cancer. 2011;11:212.CrossRefPubMedPubMedCentral
14.
go back to reference Kang KC, Cho GS, Han SU, Kim W, Kim HH, Kim MC, et al. Comparison of Billroth I and Billroth II reconstructions after laparoscopy-assisted distal gastrectomy: a retrospective analysis of large-scale multicenter results from Korea. Surg Endosc. 2011;25:1953.CrossRefPubMed Kang KC, Cho GS, Han SU, Kim W, Kim HH, Kim MC, et al. Comparison of Billroth I and Billroth II reconstructions after laparoscopy-assisted distal gastrectomy: a retrospective analysis of large-scale multicenter results from Korea. Surg Endosc. 2011;25:1953.CrossRefPubMed
15.
go back to reference Kojima K, Yamada H, Inokuchi M, Kawano T, Sugihara KA. Comparison of Roux-en-Y and Billroth-I reconstruction after laparoscopy-assisted distal gastrectomy. Ann Surg. 2008;247:962.CrossRefPubMed Kojima K, Yamada H, Inokuchi M, Kawano T, Sugihara KA. Comparison of Roux-en-Y and Billroth-I reconstruction after laparoscopy-assisted distal gastrectomy. Ann Surg. 2008;247:962.CrossRefPubMed
16.
go back to reference Piessen G, Triboulet JP, Mariette C. Reconstruction after gastrectomy: which technique is best? J Visc Surg. 2010;147, e273.CrossRefPubMed Piessen G, Triboulet JP, Mariette C. Reconstruction after gastrectomy: which technique is best? J Visc Surg. 2010;147, e273.CrossRefPubMed
17.
go back to reference Kim BJ, O’Connell T. Gastroduodenostomy after gastric resection for cancer. Am Surg. 1999;65:905.PubMed Kim BJ, O’Connell T. Gastroduodenostomy after gastric resection for cancer. Am Surg. 1999;65:905.PubMed
18.
go back to reference Kumagai K, Shimizu K, Yokoyama N, Aida S, Arima S, Aikou T. Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan. Surg Today. 2012;42:411.CrossRefPubMed Kumagai K, Shimizu K, Yokoyama N, Aida S, Arima S, Aikou T. Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan. Surg Today. 2012;42:411.CrossRefPubMed
19.
go back to reference Shinoto K, Ochiai T, Suzuki T, Okazumi S, Ozaki M. Effectiveness of Roux-en-Y reconstruction after distal gastrectomy based on an assessment of biliary kinetics. Surg Today. 2003;33:169.CrossRefPubMed Shinoto K, Ochiai T, Suzuki T, Okazumi S, Ozaki M. Effectiveness of Roux-en-Y reconstruction after distal gastrectomy based on an assessment of biliary kinetics. Surg Today. 2003;33:169.CrossRefPubMed
20.
go back to reference Fukuhara K, Osugi H, Takada N, Takemura M, Higashino M, Kinoshita H. Reconstructive procedure after distal gastrectomy for gastric cancer that best prevents duodenogastroesophageal reflux. World J Surg. 2002;26:1452.CrossRefPubMed Fukuhara K, Osugi H, Takada N, Takemura M, Higashino M, Kinoshita H. Reconstructive procedure after distal gastrectomy for gastric cancer that best prevents duodenogastroesophageal reflux. World J Surg. 2002;26:1452.CrossRefPubMed
21.
go back to reference Hoya Y, Mitsumori N, Yanaga K. The advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer. Surg Today. 2009;39(8): 647–51.CrossRefPubMed Hoya Y, Mitsumori N, Yanaga K. The advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer. Surg Today. 2009;39(8): 647–51.CrossRefPubMed
23.
go back to reference Bouras G, Lee SW, Nomura E, Tokuhara T, Nitta T, Yoshinaka R, et al. Surgical outcomes from laparoscopic distal gastrectomy and Roux-en-Y reconstruction: evolution in a totally intracorporeal technique. Surg Laparosc Endosc Percutan Tech. 2011;21:37.CrossRefPubMed Bouras G, Lee SW, Nomura E, Tokuhara T, Nitta T, Yoshinaka R, et al. Surgical outcomes from laparoscopic distal gastrectomy and Roux-en-Y reconstruction: evolution in a totally intracorporeal technique. Surg Laparosc Endosc Percutan Tech. 2011;21:37.CrossRefPubMed
24.
go back to reference Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14:365.CrossRefPubMed Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14:365.CrossRefPubMed
25.
go back to reference Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc. 2009;23:2624.CrossRefPubMed Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc. 2009;23:2624.CrossRefPubMed
Metadata
Title
Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes
Authors
Ke Chen
Di Wu
Yu Pan
Jia-Qin Cai
Jia-Fei Yan
Ding-Wei Chen
Hendi Maher
Yi-Ping Mou
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0868-7

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