Circular versus linear stapling in esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer: a propensity score-matched study
| Autor: | Toshiaki Shichinohe, Takayuki Morita, Shunichi Okushiba, Katsuhiko Murakawa, Yuma Ebihara, Fumitaka Nakamura, Noriaki Kyogoku, Satoshi Hirano |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Matched-Pair Analysis Kaplan-Meier Estimate Anastomosis Laparoscopic total gastrectomy Postoperative complications 03 medical and health sciences Esophagus 0302 clinical medicine Gastrectomy Stomach Neoplasms Propensity score matching Surgical Stapling Humans Medicine Propensity Score Laparoscopy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Anastomosis Surgical Postoperative complication Middle Aged Surgery Dissection Jejunum Treatment Outcome Cardiothoracic surgery 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Gastric cancer business Complication Esophagojejunostomy Abdominal surgery |
| Zdroj: | Langenbeck's Archives of Surgery. 403:463-471 |
| ISSN: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-018-1678-x |
| Popis: | Purpose: We used propensity score matching to compare the complication rates after laparoscopic total gastrectomy (LTG) with esophagojejunostomy (EJS) performed using a circular or a linear stapler. Methods: We retrospectively enrolled all patients who underwent curative LTG between November 2004 and March 2016. Patients were categorized into the circular and linear groups according to the stapler type used for the subsequent EJS. Patients in the groups were matched using the following propensity score covariates: age, sex, body mass index, American Society of Anesthesiologists physical status, extent of lymph node dissection, and Japanese Classification of Gastric Carcinoma stage. Clinicopathological characteristics and surgical outcomes were compared. Results: We identified 66 propensity score-matched pairs among 379 patients who underwent LTG. There was no significant between-group difference in the median operative time, extent of lymph node dissection, number of lymph nodes resected, rate of conversion to open surgery, or number of surgeries performed by a surgeon certified by the Japanese Society of Endoscopic Surgery. In the circular and linear groups, the rate of all complications (Clavien-Dindo [CD] classification ≥ I; 21 vs. 26%, respectively; p = 0.538), complications more severe than CD grade III (14 vs. 14%, respectively; p = 1.000), and occurrence of EJS leakage and stenosis more severe than CD grade III (5 vs. 2%, p = 0.301; 9 vs. 8%, p = 0.753, respectively) were comparable. Conclusions: There is no difference in the postoperative complication rate related to the type of stapler used for EJS after LTG. |
| Databáze: | OpenAIRE |
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