A novel intracorporeal esophagojejunostomy and esophagogastrostomy following laparoscopic gas-trectomy

Abstract

Objective To evaluate the clinical value of a novel anvil insertion technique in intracor- poreal esophagojejunostomy and esophagogastrostomy after laparoscopic total or proximal gastrectomy. Meth- ods A total of 40 patients with gastric cancer underwent laparoscopy-assisted radical total or proximal gas- trectomy with lymph node dissection, followed by esophagojejunostomy or esophagogastrostomy using a reverse anvil insertion technique （ the observation group, n = 22） or traditional open surgery technique （ the control group, n = 18）. Data of the two groups were compared. Results In observation group, laparoscopic total gastrectomy and esophagojejunostomy were successfully performed in 17 patients, laparoscopic proximal gas- trectomy and esophagogastrostomy were successfully performed in the 5 patients, and no conversion to open surgery occurred. The mean time of operation was （272.0 ±49. 8 ） rain, including （ 12. 9 ± 4. 3 ） min for an- vii insertion and （48.1 ±12. 8 ）min for digestive tract reconstruction, which were significantly shorter than those in control group （P 〈 0. 05 ）. The mean time of getting out of bed in observation group was （ 3. 4 ~ 0. 8） d, the mean time of post-surgical eating was （8.0 ± 2. 6） d, and the mean time of hospitalization was （ 10. 8±3. 3）d, which were all similar with those from the control group （P 〉0. 05）. Conclusion The re- verse anvil insertion technique is a reliable strategy for laparoscopic esophagojejunostomy or esophagogastros- tomy. Key words: Gastrectomy; Anastomosis, surgical; Laparoscopic surgical procedures