title: [Laparoscopic gastrectomy for gastric stump cancer: analysis of 7 cases].
abstract: OBJECTIVE
  To evaluate the safety and feasibility of laparoscopic gastrectomy for gastric stump cancer.
  
  
  METHODS
  Clinical and follow-up data of 7 patients who underwent laparoscopic gastrectomy for gastric stump cancer in our department from January 2008 to July 2015 were analyzed retrospectively.
  
  
  RESULTS
  There were 5 male and 2 female patients, with a mean age of (62.1±10.7) years. Initial gastrectomy was performed for gastric cancer in 3 patients and peptic ulceration in 4. The initial surgery was B-II( gastrojejunostomy in 6 patients and Roux-en-Y gastrojejunostomy in 1. Duration between primary gastrectomy and occurrence of gastric stump cancer was ranged from 6-30 years for peptic ulceration, and from 11-15 years for gastric cancer. During the operation, adhesiolysis and exploration to locate the tumor were performed. Following total remnant gastrectomy and lymphadenectomy, intracorporeal anastomosis was accomplished by Roux-en-Y reconstruction. The methods of intracorporeal esophagojejunostomy were end-to-side approach using a circular stapler in 1 patient, side-to-side approach using an endoscopic linear staple in 2 patients, and hand-sewn technique in 4 patients. The operation time was (247.1±17.5) minutes and the intraoperative blood loss was (100.0±30.8) ml without transfusion. The number of retrieved lymph node was 19.1±4.8. The first flatus time, diet resumption time, postoperative hospital stay were (3.3±1.5) days, (3.7±0.8) days, (9.4±2.6) days, respectively. One patient experienced gastrointestinal bleeding that was managed conservatively and ultimately cured. Seven patients were followed up till January 2016. After follow-up from 6 to 38 months, 1 patient died of peritoneal metastasis 17 months after surgery, and 1 patient died of Alzheimer's disease 19 months after surgery. The other 5 patients were still alive without metastasis or recurrence.
  
  
  CONCLUSIONS
  Laparoscopic gastrectomy for gastric stump cancer is feasible and safe.
authors.forename: Renchao
authors.initials: R
authors.lastname: Zhang
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China. yipingmou@126.com.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Mou
authors.forename: Yucheng
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jiayu
authors.initials: J
authors.lastname: Zhou
authors.forename: Chaojie
authors.initials: C
authors.lastname: Huang
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D016063:Blood Loss, Surgical; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D018530:Gastric Stump / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling