Modified techniques and early outcomes of totally laparoscopic total gastrectomy with side-to-side esophagojejunostomy

J Laparoendosc Adv Surg Tech A. 2012 Nov;22(9):876-80. doi: 10.1089/lap.2012.0177. Epub 2012 Oct 11.

Abstract

Background: Construction of an esophagojejunostomy is a major concern in totally laparoscopic total gastrectomy (TLTG). Use of a circular stapler can be technically challenging in laparoscopic procedures. We aimed to introduce our modified techniques and to assess the early outcomes following TLTG with side-to-side esophagojejunostomy using a linear stapler in patients with gastric cancer.

Subjects and methods: From December 2010 to June 2011, 27 patients who underwent TLTG for gastric cancer were retrospectively reviewed. Their clinicopathologic characteristics, surgical time, hospital stay, morbidity, and mortality were analyzed.

Results: The mean age of patients was 59.1 years, and the average body mass index was 24.6 kg/m(2). The mean operating time was 126.2 minutes, and the hospital stay averaged 8.1 days. No conversion to open laparotomy was required. There were 2 luminal bleeding cases and 1 intra-abdominal bleeding case, but all were successfully managed with conservative treatment only. No patient experienced reoperation, anastomosis leakage, stricture, duodenal stump leakage, or wound problems.

Conclusions: Our TLTG with side-to-side esophagojejunostomy method can be a feasible and safe option for patients with gastric cancer.

MeSH terms

  • Adult
  • Aged
  • Esophagus / surgery*
  • Female
  • Gastrectomy / methods*
  • Humans
  • Jejunostomy / methods*
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Retrospective Studies
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery*
  • Surgical Stapling
  • Treatment Outcome