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Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes.

Chen K, Wu D, Pan Y, Cai JQ, Yan JF, Chen DW, Maher H, Mou YP - World J Surg Oncol (2016)

Bottom Line: For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively.Postoperative complications were observed in 65 patients.All of the patients recovered well without perioperative death by conservative or surgical management.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qing Chun Road, Hangzhou, 310016, Zhejiang Province, China.

ABSTRACT

Background: Totally laparoscopic gastrectomy (TLG) using intracorporeal anastomosis has gradually become mature thanks to the advancements of laparoscopic surgical instruments and the accumulation of operative experience. The goal of this study is to review our institution's experience with TLG for the treatment of gastric cancer.

Methods: A retrospective study was conducted to examine the short-term outcomes of TLG using intracorporeally stapler or hand-sewn anastomosis performed at Sir Run Run Shaw Hospital between March 2007 and June 2015. The details of intracorporeal anastomosis were described, and the clinicopathological data, surgical outcomes, and postoperative complications were evaluated.

Results: Four hundred seventy-eight patients were included in the study. Generally speaking, the patients could be divided into stapler or hand-sewn groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 97) or only stapling devices (n = 381). For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively. Postoperative complications were observed in 65 patients. All of the patients recovered well without perioperative death by conservative or surgical management.

Conclusions: TLG using intracorporeally stapler or hand-sewn anastomosis is a reasonable option for the treatment of gastric cancer, with early data showing acceptable perioperative outcomes.

No MeSH data available.


Related in: MedlinePlus

Trocar placement and incision. a Location of trocar placement and incision. b Postoperative view of the abdominal wound
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Fig1: Trocar placement and incision. a Location of trocar placement and incision. b Postoperative view of the abdominal wound

Mentions: Under general anesthesia, the patient was placed in supine position. Mobilization of the stomach and en bloc systematic lymph node dissection were performed via five trocars under a pneumoperitoneum (Fig. 1a). Sufficient lymphadenectomy is performed, and the stomach is transected. The resected specimen is removed through the extended umbilical incision, using a large plastic bag. An approximately 3–4-cm longitudinal incision was made to remove the specimen. The extended umbilical incision normally shrinks well within a few months (Fig. 1b). The detailed lymphadenectomy and resection procedure was described in our previously published articles [8–10].Fig. 1


Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes.

Chen K, Wu D, Pan Y, Cai JQ, Yan JF, Chen DW, Maher H, Mou YP - World J Surg Oncol (2016)

Trocar placement and incision. a Location of trocar placement and incision. b Postoperative view of the abdominal wound
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837503&req=5

Fig1: Trocar placement and incision. a Location of trocar placement and incision. b Postoperative view of the abdominal wound
Mentions: Under general anesthesia, the patient was placed in supine position. Mobilization of the stomach and en bloc systematic lymph node dissection were performed via five trocars under a pneumoperitoneum (Fig. 1a). Sufficient lymphadenectomy is performed, and the stomach is transected. The resected specimen is removed through the extended umbilical incision, using a large plastic bag. An approximately 3–4-cm longitudinal incision was made to remove the specimen. The extended umbilical incision normally shrinks well within a few months (Fig. 1b). The detailed lymphadenectomy and resection procedure was described in our previously published articles [8–10].Fig. 1

Bottom Line: For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively.Postoperative complications were observed in 65 patients.All of the patients recovered well without perioperative death by conservative or surgical management.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qing Chun Road, Hangzhou, 310016, Zhejiang Province, China.

ABSTRACT

Background: Totally laparoscopic gastrectomy (TLG) using intracorporeal anastomosis has gradually become mature thanks to the advancements of laparoscopic surgical instruments and the accumulation of operative experience. The goal of this study is to review our institution's experience with TLG for the treatment of gastric cancer.

Methods: A retrospective study was conducted to examine the short-term outcomes of TLG using intracorporeally stapler or hand-sewn anastomosis performed at Sir Run Run Shaw Hospital between March 2007 and June 2015. The details of intracorporeal anastomosis were described, and the clinicopathological data, surgical outcomes, and postoperative complications were evaluated.

Results: Four hundred seventy-eight patients were included in the study. Generally speaking, the patients could be divided into stapler or hand-sewn groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 97) or only stapling devices (n = 381). For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively. Postoperative complications were observed in 65 patients. All of the patients recovered well without perioperative death by conservative or surgical management.

Conclusions: TLG using intracorporeally stapler or hand-sewn anastomosis is a reasonable option for the treatment of gastric cancer, with early data showing acceptable perioperative outcomes.

No MeSH data available.


Related in: MedlinePlus