Four stay-sutures method: a simplified hand-sewn purse-string suture in laparoscopic circular-stapled esophagojejunostomy

Autor: Hiroshi Saeki, Kyoichi Ogata, Yasushi Mochida, Hitoshi Ojima, Hiroshi Naitoh, Kana Saito, Minoru Fukuchi, Atsushi Ogawa, Akihiko Sano, Ken Shirabe, Takaharu Fukasawa, Yasuyuki Fukai, Makoto Sohda
Rok vydání: 2019
Předmět:
Zdroj: Surgery Today. 50:314-319
ISSN: 1436-2813
0941-1291
DOI: 10.1007/s00595-019-01867-w
Popis: Laparoscopic esophagojejunostomy is a challenging procedure because of its technical difficulty. We herein report a new method involving circular-stapled anastomosis using a hand-sewn suture with four stay-sutures and evaluate its outcomes. Esophagojejunostomy using this method was performed in 36 consecutive patients with clinical stage I gastric cancer at the authors' institutions. The key feature of our procedure was the placement of four full-thickness stay-sutures to anchor the esophageal stump prior to the hand-sewn purse-string suture. The median operation time and mean anvil fixation time were 315.5 and 21.9 min, respectively. The mortality rate was 0%, although anastomotic leakage following esophagojejunostomy was observed in 1 patient (2.8%), and anastomotic stenosis was observed in another patient (2.8%). Intracorporeal esophagojejunostomy using the four stay-sutures method appears to be safe and feasible. We believe that this method enables hand-sewn purse-string suturing to be performed more easily.
Databáze: OpenAIRE
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