Hemi‐double stapling technique performed with a transorally inserted anvil for esophagojejunostomy in the surgical treatment of gastric cancer
| Autor: | Shun Zhang, Satoshi Kanda, Yuji Ishibashi, Wu Jianzhong, Yukinori Yube, Shinichi Oka, Tetsu Fukunaga, Sanae Kaji, Yoshinori Kohira, Hiroki Egawa |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Operative Time Jejunostomy Anastomosis Blood loss Gastrectomy Stomach Neoplasms Surgical Stapling Humans Medicine Laparoscopic total gastrectomy Esophagus Surgical treatment Aged Retrospective Studies Stapled anastomosis business.industry Anastomosis Surgical General Medicine Middle Aged medicine.disease Surgery Stenosis medicine.anatomical_structure Anastomotic leakage Feasibility Studies Female Laparoscopy Esophagostomy business |
| Zdroj: | Asian Journal of Endoscopic Surgery. 13:168-174 |
| ISSN: | 1758-5910 1758-5902 |
| Popis: | Introduction A transorally inserted anvil has been developed to facilitate the creation of a stapled anastomosis without the need for a purse string to secure the anvil into place during laparoscopic total gastrectomy (LTG). We describe a hemi-double stapling technique and application of a transorally inserted anvil for esophagojejunostomy during LTG, and we report the results of a retrospective study in which we examined the feasibility and safety of this method. We also describe the key technical details of the method. Methods Our anastomotic method has four chief features: (a) the esophagus is cut at a slant, and its left cut end is cut and punched for the hemi-double stapling technique; (b) the anvil and circular stapler are connected, placing the distal jejunum in cranial traction; (c) a single layer of sutures is used to correct dog-earing and overlapping, and these points are completely closed with Lembert sutures; and (d) the jejunal limb is fixed to the duodenal stump to prevent kinking of the jejunal limb and to decrease tension on the anastomosis. Results This method has been used in 53 patients thus far. LTG with Roux-en-Y reconstruction was successful in all patients, and there was no need for conversion to open surgery. The mean operative time was 313 minutes, and the mean blood loss was 106 mL. The mean postoperative hospital stay was 18 days. There was no anastomotic leakage or stenosis. Conclusion Hemi-double stapling technique with a transorally inserted anvil for LTG can be performed safely and easily and safely. It can also product good outcomes. |
| Databáze: | OpenAIRE |
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