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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

Intracorporeal hand-sewn end-to-side esophagojejunostomy. a The jejunum and esophageal stump attached to each other with seromuscular sutures. b A 2-cm-wide incision at the antimesenteric side of the jejunum. c Suture of the posterior wall using interrupted sutures. d Suture of the anterior wall using a continuous suture. e Strengthening of the seromuscular layer with interrupted sutures. f Complete esophagojejunostomy
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Fig4: Intracorporeal hand-sewn end-to-side esophagojejunostomy. a The jejunum and esophageal stump attached to each other with seromuscular sutures. b A 2-cm-wide incision at the antimesenteric side of the jejunum. c Suture of the posterior wall using interrupted sutures. d Suture of the anterior wall using a continuous suture. e Strengthening of the seromuscular layer with interrupted sutures. f Complete esophagojejunostomy

Mentions: Hand-sewn methods (type C): The jejunal loop was brought up to reach the esophageal stump. The jejunum was anchored to the esophageal stump by several serosal muscularis interrupted sutures placed to the posterior layer of the esophageal stump (Fig. 4a). Two small holes were created: one on the antimesenteric side of the jejunum and the other on the esophageal stump (Fig. 4b). The posterior wall was closed by several full-thickness interrupted sutures (Fig. 4c), and closure of the anterior wall was carried out by a full-thickness continuous suture (Fig. 4d). The seromuscular layer was strengthened with interrupted sutures to reduce tension (Fig. 4e, f).Fig. 4


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)

Intracorporeal hand-sewn end-to-side esophagojejunostomy. a The jejunum and esophageal stump attached to each other with seromuscular sutures. b A 2-cm-wide incision at the antimesenteric side of the jejunum. c Suture of the posterior wall using interrupted sutures. d Suture of the anterior wall using a continuous suture. e Strengthening of the seromuscular layer with interrupted sutures. f Complete esophagojejunostomy
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Intracorporeal hand-sewn end-to-side esophagojejunostomy. a The jejunum and esophageal stump attached to each other with seromuscular sutures. b A 2-cm-wide incision at the antimesenteric side of the jejunum. c Suture of the posterior wall using interrupted sutures. d Suture of the anterior wall using a continuous suture. e Strengthening of the seromuscular layer with interrupted sutures. f Complete esophagojejunostomy
Mentions: Hand-sewn methods (type C): The jejunal loop was brought up to reach the esophageal stump. The jejunum was anchored to the esophageal stump by several serosal muscularis interrupted sutures placed to the posterior layer of the esophageal stump (Fig. 4a). Two small holes were created: one on the antimesenteric side of the jejunum and the other on the esophageal stump (Fig. 4b). The posterior wall was closed by several full-thickness interrupted sutures (Fig. 4c), and closure of the anterior wall was carried out by a full-thickness continuous suture (Fig. 4d). The seromuscular layer was strengthened with interrupted sutures to reduce tension (Fig. 4e, f).Fig. 4

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