Advantageous Short-Term Outcomes of Esophagojejunostomy Using a Linear Stapler Following Open Total Gastrectomy Compared with a Circular Stapler

2021 ◽  
Author(s):  
Yusuke Muneoka ◽  
Manabu Ohashi ◽  
Rie Makuuchi ◽  
Satoshi Ida ◽  
Koshi Kumagai ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Circular Stapler ◽  
Linear Stapler ◽  
Short Term ◽  
Open Total Gastrectomy

scholarly journals Step-by-step esophagojejunal anastomosis after intra-corporeal total gastrectomy for laparoscopic gastric cancer treatment: technique of "reverse anvil"

2014 ◽  
Vol 27 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Croider Franco LACERDA ◽  
Paulo Anderson BERTULUCCI ◽  
Antônio Talvane Torres de OLIVEIRA
Keyword(s):  
Total Gastrectomy ◽  
Circular Stapler ◽  
Jejunal Loop ◽  
Linear Stapler ◽  
Treatment Technique ◽  
Esophagojejunal Anastomosis ◽  
Technical Details ◽  
Gastric Cancer Treatment ◽  
Gastric Tubes ◽  
The Moment

Background: The laparoscopic gastrectomy is a relatively new procedure due mainly to the difficulties related to lymphadenectomy and reconstruction. Until the moment, technique or device to perform the esophagojejunal anastomosis by laparoscopy is still a challenge. So, a safe, cheap and quickly performing technique is desirable to be developed. Aim : To present technique proposed by the authors with its technical details on reconstruction with "reverse anvil". Method: After total gastrectomy completed intra-corporeally, the reconstruction starts with the preparation of the intra-abdominal esophagus cross-section next to the esophagogastric transition of 50%. A graduated device is prepared using Levine gastric tubes (nº. 14 and 10), 3 cm length, connected to the anvil of the circular stapler (nº. 25) with a wire thread (2-0 or 3-0) of 10 cm, which is connected to end of this device. The whole device is introduced in reverse esophagus. The esophagus is amputated and the wire is pulled after previous transfixation in the distal esophagus and the anvil positioned. The jejunal loop is sectioned 20-30 cm from duodenojejunal angle, and the anvil put in the jejunal loop and connect previously in the esophagus. Linear stapler (blue 60 mm) is used to close the opening of the jejunal loop. Conclusion: The "reverse anvil" technique used by the authors facilitated the transit reestablishment after total gastrectomy, contributing to obviate reconstruction problems after total gastrectomy.

scholarly journals Comparisons of short-term and survival outcomes of laparoscopy-assisted versus open total gastrectomy for gastric cancer patients

Oncotarget ◽  
2017 ◽  
Vol 8 (32) ◽  
pp. 52366-52380 ◽  
Author(s):  
Xin-Zu Chen ◽  
Shao-Yong Wang ◽  
Yin-Su Wang ◽  
Zi-Han Jiang ◽  
Wei-Han Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Survival Outcomes ◽  
Short Term ◽  
Open Total Gastrectomy ◽  
Gastric Cancer Patients

Short-term outcomes of laparoscopic versus open total gastrectomy: a matched-cohort study

2013 ◽  
Vol 206 (3) ◽  
pp. 346-351 ◽  
Author(s):  
Jung Ho Shim ◽  
Seong Il Oh ◽  
Han Mo Yoo ◽  
Hae Myung Jeon ◽  
Cho Hyun Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Total Gastrectomy ◽  
Matched Cohort ◽  
Short Term ◽  
Matched Cohort Study ◽  
Open Total Gastrectomy

scholarly journals Feasibility and Short-Term Outcomes of Three-Dimensional Hand-Sewn Esophago-Jejunal Anastomosis in Completely Laparoscopic Total Gastrectomy for Cancer

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4709
Author(s):  
Alexandros Charalabopoulos ◽  
Spyridon Davakis ◽  
Panorea Paraskeva ◽  
Nikolaos Machairas ◽  
Αlkistis Kapelouzou ◽  
...  
Keyword(s):  
Anastomotic Leak ◽  
Total Gastrectomy ◽  
Operating Time ◽  
Three Dimensional ◽  
Circular Stapler ◽  
Laparoscopic Total Gastrectomy ◽  
Linear Stapler ◽  
Limited Data ◽  
Stricture Rate ◽  
Siewert Type Iii

Laparoscopic total gastrectomy is on the rise. One of the most technically demanding steps of the approach is the construction of esophago-jejunal anastomosis. Several laparoscopic anastomotic techniques have been described, like linear stapler side-to-side or circular stapler end-to-side anastomosis; limited data exist regarding hand-sewn esophago-jejunal anastomosis. The study took place between January 2018 and June 2021. Patients enrolled in this study were adults with proximal gastric or esophago-gastric junction Siewert type III tumors that underwent 3D-assisted laparoscopic total gastrectomy. A hand-sewn esophago-jejunal anastomosis was performed in all cases laparoscopically. Forty consecutive cases were performed during the study period. Median anastomotic suturing time was 55 min, with intra-operative methylene blue leak test being negative in all cases. Median operating time was 240 min, and there were no conversions to open. The anastomotic leak rate and postoperative stricture rate were zero. The 30- and 90-day mortality rates were zero. Laparoscopic manual esophago-jejunal anastomosis utilizing a 3D platform in total gastrectomy for cancer can be performed with excellent outcomes regarding anastomotic leak and stricture rate. This anastomotic approach, although technically challenging, is safe and reproducible, with prominent results that can be disseminated in the surgical community.

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