Modified techniques and early outcomes of totally laparoscopic total gastrectomy with side-to-side esophagojejunostomy.
BACKGROUND
Construction of an esophagojejunostomy is a major concern in totally laparoscopic total gastrectomy (TLTG). Use of a circular stapler can be technically challenging in laparoscopic procedures. We aimed to introduce our modified techniques and to assess the early outcomes following TLTG with side-to-side esophagojejunostomy using a linear stapler in patients with gastric cancer.


METHODS
From December 2010 to June 2011, 27 patients who underwent TLTG for gastric cancer were retrospectively reviewed. Their clinicopathologic characteristics, surgical time, hospital stay, morbidity, and mortality were analyzed.


RESULTS
The mean age of patients was 59.1 years, and the average body mass index was 24.6 kg/m(2). The mean operating time was 126.2 minutes, and the hospital stay averaged 8.1 days. No conversion to open laparotomy was required. There were 2 luminal bleeding cases and 1 intra-abdominal bleeding case, but all were successfully managed with conservative treatment only. No patient experienced reoperation, anastomosis leakage, stricture, duodenal stump leakage, or wound problems.


CONCLUSIONS
Our TLTG with side-to-side esophagojejunostomy method can be a feasible and safe option for patients with gastric cancer.
Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, Seoul, Korea.
In-Seob
IS
Lee
Tae-Hwan
TH
Kim
Kab-Choong
KC
Kim
Jeong-Hwan
JH
Yook
Byung-Sik
BS
Kim
D000328:Adult; D000368:Aged; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D017792:Surgical Stapling; D016896:Treatment Outcome