scholarly journals Functional evaluations comparing the double-tract method and the jejunal interposition method following laparoscopic proximal gastrectomy for gastric cancer: an investigation including laparoscopic total gastrectomy

Surgery Today ◽  
2018 ◽  
Vol 49 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Eiji Nomura ◽  
Hajime Kayano ◽  
Sang-Woong Lee ◽  
Masaru Kawai ◽  
Takashi Machida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Jejunal Interposition ◽  
Laparoscopic Proximal Gastrectomy

scholarly journals Laparoscopic Proximal Gastrectomy Versus Laparoscopic Total Gastrectomy for Proximal Gastric Cancer: A Systematic Review and Meta−Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Peirong Tian ◽  
Yang Liu ◽  
Shibo Bian ◽  
Mengyi Li ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Lymph Nodes ◽  
Total Gastrectomy ◽  
Reflux Esophagitis ◽  
Proximal Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Anastomotic Stenosis ◽  
Proximal Gastric Cancer ◽  
Laparoscopic Proximal Gastrectomy

BackgroundTo compare laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) with regard to outcomes, including efficacy and safety, in patients with proximal gastric cancer.MethodsOriginal English-language articles comparing LPG and LTG for proximal gastric cancer up to November 2019 were systematically searched in the Embase, PubMed, Cochrane Library, Web of Knowledge, and ClinicalTrials.gov databases by two independent reviewers. Our main endpoints were surgery-related features (operation time, blood loss, harvested lymph nodes, and postoperative hospital stay), postoperative complications (anastomotic leakage, anastomotic bleeding, anastomotic stenosis, and reflux esophagitis), and oncologic outcomes (5-year overall survival and recurrent cancer).ResultsFourteen studies including a total of 1,282 cases (510 LPG and 772 LTG) were enrolled. Fewer lymph nodes were harvested (WMD = −13.33, 95% CI: −15.66 to −11.00, P < 0.00001) and more postoperative anastomotic stenosis (OR = 2.03, 95% CI: 1.21 to 3.39, P = 0.007) observed in LPG than LTG. There were no significant differences in other explored parameters between the two methods. However, based on a subgroup analysis of digestive tract reconstruction, LPG with esophagogastrostomy (LPG-EG) had shorter operative time (WMD = −42.51, 95% CI: −58.99 to −26.03, P < 0.00001), less intraoperative blood loss (WMD = −79.52, 95% CI: −116.63 to −42.41, P < 0.0001), and more reflux esophagitis (OR = 3.92, 95% CI: 1.56 to 9.83, P = 0.004) than was observed for LTG. There was no difference between LPG performed with the double tract anastomosis/double-flap technique (DT/DFT) and LTG.ConclusionLPG can be performed as an alternative to LTG for proximal gastric cancer, especially LPG-DT/DFT, with comparable safety and efficacy.

scholarly journals Intrathoracic Hernia after Total Gastrectomy

2016 ◽  
Vol 10 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Yoshihiko Tashiro ◽  
Masahiko Murakami ◽  
Koji Otsuka ◽  
Kazuhiko Saito ◽  
Akira Saito ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leakage ◽  
Total Gastrectomy ◽  
Transverse Colon ◽  
Proximal Gastrectomy ◽  
Abdominal Cavity ◽  
Roux Limb ◽  
X Rays ◽  
Thoracic Cavity ◽  
Laparoscopic Proximal Gastrectomy

Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

scholarly journals Outcomes of laparoscopic proximal gastrectomy with jejunal interposition for proximal early gastric cancer

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Trung Lam ◽  
Vo Vinh Loc Nguyen
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Case Series ◽  
Jejunal Interposition ◽  
Surgical Approaches ◽  
Safe Procedure ◽  
Female Ratio ◽  
Laparoscopic Proximal Gastrectomy

Abstract Introduction: Proximal gastrectomy is one of the modified surgical approaches for early gastric cancer located in the upper stomach instead of total gastrectomy. The preserving stomach helps for storage, digestion, and absorption of food and prevents anemia. Proximal gastrectomy with jejunal interinterposition has been reported to prevent and diminuate postoperative complications, such as reflux esophagitis and anastomotic stricture. Laparoscopic proximal gastrectomy (LPG) with jejunal interposition has been reported in the world with promising results. Aim of this study is to evaluate the feasibility and results of LPG with jejunal interposition for proximal early gastric cancer. Material and Methods: Descriptive prospective study ofconsecutive cases of laparoscopic proximal gastrectomy for early gastric cancer located in the upper stomach was conducted at Department of Digestive Surgery of Cho Ray hospital from 1/2015 to 6/2018, . Results: Of 8 cases of LPG for early gastric cancer located in the upper stomach was enrolled. Patients mean age was 55,5. Male/female ratio was 3/1. Tumor located at cardia in 7 cases and in fundus in 1 case. All the tumors were adenocarcinoma at cT1N0M0 stage. Mean operative time was 150 minutes. There was no intraoperative accident. Mean harvested lymph nodes were 5. There was no lymph node metastasis. No morbidity was noted. Mean postoperative hospital stay was 7 days. All patients tolerated well with food and have no regurgitation. With mean follow-up period of 28 months, there was no recurrence and mortality. Conclusion: Our initial case series demonstrated that LPG with jejunal interposition is a feasible, safe procedure and offering good functional and oncological outcomes. Futher follow-up time and more data should be needed to evaluate the effectiveness of this operation.

Functional Advantages of Proximal Gastrectomy with Jejunal Interposition Over Total Gastrectomy with Roux-en-Y Esophagojejunostomy for Early Gastric Cancer

2015 ◽  
Vol 39 (11) ◽  
pp. 2726-2733 ◽  
Author(s):  
Masaki Ohashi ◽  
Shinji Morita ◽  
Takeo Fukagawa ◽  
Ichiro Oda ◽  
Ryoji Kushima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Jejunal Interposition

Long-term Outcome after Proximal Gastrectomy with Jejunal Interposition for Gastric Cancer Compared with Total Gastrectomy

2012 ◽  
Vol 37 (3) ◽  
pp. 558-564 ◽  
Author(s):  
Isao Nozaki ◽  
Shinji Hato ◽  
Takaya Kobatake ◽  
Koji Ohta ◽  
Yoshirou Kubo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Jejunal Interposition ◽  
Term Outcome ◽  
Long Term Outcome
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