DOI QR코드

DOI QR Code

Totally Laparoscopic Total Gastrectomy Using Intracorporeally Hand-Sewn Esophagojejunostomy

  • 투고 : 2011.09.30
  • 심사 : 2011.11.03
  • 발행 : 2011.12.30

초록

Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

키워드

참고문헌

  1. Azagra JS, Goergen M, De Simone P, Ibanez-Aguirre J. The current role of laparoscopic surgery in the treatment of benign gastroduodenal diseases. Hepatogastroenterology 1999;46:1522-1526.
  2. Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, et al. Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 1999;229:49-54. https://doi.org/10.1097/00000658-199901000-00006
  3. Kim MC, Kim KH, Kim HH, Jung GJ. Comparison of laparoscopy-assisted by conventional open distal gastrectomy and extraperigastric lymph node dissection in early gastric cancer. J Surg Oncol 2005;91:90-94. https://doi.org/10.1002/jso.20271
  4. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N; Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 2007;245:68-72. https://doi.org/10.1097/01.sla.0000225364.03133.f8
  5. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005;241:232-237. https://doi.org/10.1097/01.sla.0000151892.35922.f2
  6. Huscher CG, Mingoli A, Sgarzini G, Brachini G, Binda B, Di Paola M, et al. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 2007;194:839-844. https://doi.org/10.1016/j.amjsurg.2007.08.037
  7. Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, et al. Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg 2007;94:204-207. https://doi.org/10.1002/bjs.5542
  8. Kim SG, Lee YJ, Ha WS, Jung EJ, Ju YT, Jeong CY, et al. LATG with extracorporeal esophagojejunostomy: is this minimal invasive surgery for gastric cancer? J Laparoendosc Adv Surg Tech A 2008;18:572-578. https://doi.org/10.1089/lap.2007.0106
  9. Usui S, Yoshida T, Ito K, Hiranuma S, Kudo SE, Iwai T. Laparoscopy-assisted total gastrectomy for early gastric cancer: comparison with conventional open total gastrectomy. Surg Laparosc Endosc Percutan Tech 2005;15:309-314. https://doi.org/10.1097/01.sle.0000191589.84485.4a
  10. Mochiki E, Toyomasu Y, Ogata K, Andoh H, Ohno T, Aihara R, et al. Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer. Surg Endosc 2008;22:1997-2002. https://doi.org/10.1007/s00464-008-0015-9
  11. Okabe H, Satoh S, Inoue H, Kondo M, Kawamura J, Nomura A, et al. Esophagojejunostomy through minilaparotomy after laparoscopic total gastrectomy. Gastric Cancer 2007;10:176-180. https://doi.org/10.1007/s10120-007-0432-9
  12. Cheong O, Kim BS, Yook JH, Oh ST, Lim JT, Kim KJ, et al. Laparoscopic assisted total gastrectomy (LATG) with extracorporeal anastomosis and using circular Stapler for middle or upper early gastric carcinoma: reviews of single Surgeon's experience of 48 consecutive patients. J Korean Gastric Cancer Assoc 2008;8:27-34. https://doi.org/10.5230/jkgca.2008.8.1.27
  13. Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A. Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 1999;2:230-234. https://doi.org/10.1007/s101200050069
  14. Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, et al. Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 2010;211:e25-e29. https://doi.org/10.1016/j.jamcollsurg.2010.09.005
  15. Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, et al. Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 2009;23:2167-2171. https://doi.org/10.1007/s00464-008-9987-8
  16. Bracale U, Marzano E, Nastro P, Barone M, Cuccurullo D, Cutini G, et al. Side-to-side esophagojejunostomy during totally laparoscopic total gastrectomy for malignant disease: a multicenter study. Surg Endosc 2010;24:2475-2479. https://doi.org/10.1007/s00464-010-0988-z
  17. Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K. Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument "Endo-PSI (II)" and circular stapler. Gastric Cancer 2008;11:233-237. https://doi.org/10.1007/s10120-008-0481-8
  18. Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 2009;23:2624-2630. https://doi.org/10.1007/s00464-009-0461-z
  19. Kunisaki C, Makino H, Oshima T, Fujii S, Kimura J, Takagawa R, et al. Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy. Surg Endosc 2011;25:1300-1305. https://doi.org/10.1007/s00464-010-1367-5
  20. Kinoshita T, Oshiro T, Ito K, Shibasaki H, Okazumi S, Katoh R. Intracorporeal circular-stapled esophagojejunostomy using hand-sewn purse-string suture after laparoscopic total gastrectomy. Surg Endosc 2010;24:2908-2912. https://doi.org/10.1007/s00464-010-1041-y
  21. Hur H, Kim JY, Cho YK, Han SU. Technical feasibility of robot-sewn anastomosis in robotic surgery for gastric cancer. J Laparoendosc Adv Surg Tech A 2010;20:693-697. https://doi.org/10.1089/lap.2010.0246

피인용 문헌

  1. Long-Term Outcomes and Feasibility with Laparoscopy-Assisted Gastrectomy for Gastric Cancer vol.12, pp.1, 2012, https://doi.org/10.5230/jgc.2012.12.1.18
  2. Intracorporeal Anastomosis in Laparoscopic Gastric Cancer Surgery vol.12, pp.3, 2012, https://doi.org/10.5230/jgc.2012.12.3.133
  3. Intracorporeal Laparoscopic Roux-en-Y Gastrojejunostomy After 95% Gastrectomy for Early Gastric Cancer in the Upper Third of the Stomach: A Report on 21 Cases vol.23, pp.3, 2011, https://doi.org/10.1089/lap.2012.0371
  4. Single Incision Laparoscopic Total Gastrectomy and D2 Lymph Node Dissection for Gastric Cancer Using a Four-Access Single Port: The First Experience vol.2013, pp.None, 2011, https://doi.org/10.1155/2013/504549
  5. Feasibility of laparoscopy-assisted total gastrectomy in patients with clinical stage I gastric cancer vol.17, pp.1, 2011, https://doi.org/10.1007/s10120-013-0235-0
  6. Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center vol.28, pp.5, 2011, https://doi.org/10.1007/s00464-013-3352-2
  7. Evaluation of the safety and efficacy of esophagojejunostomy after totally laparoscopic total gastrectomy using a trans-orally inserted anvil: a single-center comparative study vol.28, pp.6, 2011, https://doi.org/10.1007/s00464-014-3417-x
  8. Totally laparoscopic versus open total gastrectomy for gastric cancer : A case-matched study about short-term outcomes vol.96, pp.38, 2011, https://doi.org/10.1097/md.0000000000008061
  9. Intracorporeal Circular Stapled Esophagojejunostomy Using Conventional Purse-String Suture Instrument After Laparoscopic Total Gastrectomy vol.27, pp.12, 2011, https://doi.org/10.1089/lap.2016.0675
  10. Intra-corporeal hand-sewn esophagojejunostomy is a safe and feasible procedure for totally laparoscopic total gastrectomy: short-term outcomes in 100 consecutive patients vol.32, pp.6, 2011, https://doi.org/10.1007/s00464-017-5964-4
  11. Laparoscopic gastrectomy using intracorporeally hand-sewn anastomosis of esophagojejunostomy, gastroduodenostomy, or gastrojejunostomy for gastric cancer vol.99, pp.5, 2011, https://doi.org/10.1097/md.0000000000019002
  12. Laparoscopic gastrectomy with D2 lymphadenectomy for gastric cancer: Short-term results from a tertiary hospital in Vietnam vol.29, pp.1, 2011, https://doi.org/10.4993/acrt.29.1
  13. Feasibility and Short-Term Outcomes of Three-Dimensional Hand-Sewn Esophago-Jejunal Anastomosis in Completely Laparoscopic Total Gastrectomy for Cancer vol.13, pp.18, 2011, https://doi.org/10.3390/cancers13184709
  14. Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer vol.19, pp.1, 2011, https://doi.org/10.1186/s12957-021-02249-8