title: Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy.
abstract: BACKGROUND
  Recently, novel intracorporeal esophagojejunostomy using a linear stapler after laparoscopic total gastrectomy (LTG) was reported and termed as the overlap method. In this study, we evaluated the feasibility and safety of the overlap method for esophagojejunostomy or esophagogastrostomy after LTG or laparoscopic proximal gastrectomy (LPG), respectively.
  
  
  METHODS
  Twenty-five patients underwent anastomosis using a linear stapler during esophagojejunostomy and esophagogastrostomy after LTG and LPG, respectively. Clinicopathological data and surgical outcomes were evaluated.
  
  
  RESULTS
  The average surgical duration for LTG was 236.8 min compared with 224.1 min for LPG. Postoperative complications were observed in four patients (16.0%); these included a wound infection, an intestinal obstruction, an afferent loop syndrome, and a reflux symptom. The average postoperative hospital stay of the patients was 12.5 days. There was no case of conversion to open surgery, anastomotic leakage or stenosis, or mortality.
  
  
  CONCLUSIONS
  The overlap method for esophagojejunostomy or esophagogastrostomy after LTG or LPG is safe and feasible and does not require an additional minilaparotomy, which may result in less pain and favorable cosmetic outcomes.
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. tsujihi@ndmc.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Uyama
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yaguchi
authors.forename: Isao
authors.initials: I
authors.lastname: Kumano
authors.forename: Risa
authors.initials: R
authors.lastname: Takahata
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Suefumi
authors.initials: S
authors.lastname: Aosasa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D015331:Cohort Studies; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome