[A new technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy].
OBJECTIVE
To report the newly developed reconstruction technique after laparoscopic total gastrectomy: intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil; Covidien), and evaluate its feasibility, safety, and clinical outcomes.


METHODS
After LTG (3 patients with gastric carcinoma in the body) or LPG (2 patients with gastric carcinoma in the cardiac and fundus, respectively, and 1 with cardiac stromal tumor), the anvil was then inserted transorally into the esophagus by using the OrVil system. Double-stapling esophagojejunostomy or esophagogastrostomy with a circular stapler was performed intracorporeally.


RESULTS
The operations were uneventful. The operative time was (183.3+/-25.8) min, and blood loss was (128.3+/-90.2) ml. Postoperative fluorography revealed no anastomotic leakage or stenosis. Patients resumed an oral liquid diet on postoperative day (4.0+/-1.1), and were discharged on day (9.0+/-2.6). Patients were followed at 28 days and no complications were reported.


CONCLUSIONS
LTG with Roux-en-Y reconstruction or LPG with esophagogastrostomy using the OrVil system appear to be safe and reliable with satisfactory short-term outcomes.
Ke
Chong-Wei
CW
Minimally Invasive Surgery Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. kezhongwei@gmail.com
Chen
Dan-Lei
DL
Ding
Dan
D
Ji
Xin-Rong
XR
Ni
Wen
W
Ruan
Xiao-Ru
XR
Li
Xiao-Mei
XM
Zheng
Cheng-Zhu
CZ
D000714:Anastomosis, Surgical; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy