title: Survey on laparoscopic total gastrectomy at the 11th China-Korea-Japan Laparoscopic Gastrectomy Joint Seminar.
abstract: BACKGROUND
  Laparoscopic total gastrectomy (LTG) has been widely performed for gastric cancer in China, Korea, and Japan. The current status of this surgical approach needs to be investigated.
  
  
  METHODS
  During the 11th China-Korea-Japan Laparoscopic Gastrectomy Joint Seminar in Shanghai, China, on 5 March 2016, a questionnaire was completed by 65 experts in LTG. The survey included questions on surgical indication, operation team, laparoscopic instruments, and operative procedures.
  
  
  RESULTS
  Of the 65 respondents, 35 (53.8%) were from China, 18 (27.7%) were from Korea, and 12 (18.5%) were from Japan. Surgeons have various indications for LTG. Among respondents, stage II gastric cancer (42.9%) was the most acceptable indication, but Japanese surgeons were more cautious on this issue (P = 0.005). Using a flexible scope was more popular with Japanese surgeons than with others (P = 0.003). A goose-neck curved grasper was used more often in China and Korea than in Japan (P = 0.006). Chinese surgeons preferred vertical subxiphoid mini-laparotomy rather than vertical transumbilical laparotomy. Intracorporeal reconstruction (73.0%) was most frequently adopted for LTG. Linear staplers (53.8%) and circular staplers (42.1%) were both popular for esophagojejunostomy. However, jejunojejunostomy was more often conducted extracorporeally (67.7%), in which case a linear stapler (86.4%) was usually selected. Significant differences were observed between the three countries with regard to reinforcement of the duodenal stump (P = 0.018) and closure of Peterson's space (P < 0.001).
  
  
  CONCLUSIONS
  This survey on LTG involving surgeons from China, Korea, and Japan clearly informed the current practice of this surgical approach and will likely aid future research studies as well as clinical treatment for gastric cancer.
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Minimally Invasive Surgery Center, Shanghai, China.
authors.forename: Zheng-Hao
authors.initials: ZH
authors.lastname: Cai
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Minimally Invasive Surgery Center, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zang
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
authors.affiliation: Oita University, Oita, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Shanghai Minimally Invasive Surgery Center, Shanghai, China.
authors.forename: Min-Hua
authors.initials: MH
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D056910:Republic of Korea; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Gastric cancer; laparoscopic total gastrectomy; survey