The Evolution of Surgical Technique for Total Gastrectomy over a 12-Year Period: A Single Institution's Experience

2012 ◽  
Vol 78 (10) ◽  
pp. 1054-1058 ◽  
Author(s):  
Amanda K. Arrington ◽  
Rebecca Nelson ◽  
Steven L. Chen ◽  
Joshua D. Ellenhorn ◽  
Julio Garcia-Aguilar ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Lymph Nodes ◽  
Total Gastrectomy ◽  
Surgical Techniques ◽  
Laparoscopic Total Gastrectomy ◽  
Estimated Blood Loss ◽  
Institutional Experience ◽  
Open Total Gastrectomy ◽  
Laparoscopic Techniques ◽  
Average Tumor Size

Despite the wide acceptance of laparoscopic surgical techniques, its use for gastric cancer has been limited. Laparoscopic total gastrectomy poses many technical challenges when compared with open gastrectomy. Our objective was to evaluate our institutional experience and surgical technique for total gastrectomy. Through a review of patients undergoing total gastrectomy (1999 to 2011), 50 patients were identified. During the first decade, 25 per cent of total gastrectomies were performed laparoscopically compared with 77 per cent since 2009. Compared with open cases, laparoscopic cases yielded a significantly higher number of examined lymph nodes (29 vs 19), lower estimated blood loss (200 vs 450 mL), and shorter length of stay (8 vs 14 days). Median operative time, average tumor size, and number of positive lymph nodes were not different. Morbidity rates were much lower in the laparoscopic series; and 30-day mortality rates were similar in both groups. Laparoscopic total gastrectomy and D2 lymphadenectomy are comparable in safety and have improved efficacy than our open total gastrectomy experience. After initiation of a laparoscopic total gastrectomy program in 2009, the majority of cases in our institution are now performed by laparoscopic techniques.

Kinh nghiệm qua 126 bệnh nhân phẫu thuật nội soi cắt toàn bộ dạ dày điều trị ung thư dạ dày

2021 ◽  
Author(s):  
Van Huong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Total Gastrectomy ◽  
Operative Time ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Linear Stapler ◽  
The Mean ◽  
End To End ◽  
Mean Time

TÓM TẮT Đặt vấn đề: Báo cáo kinh nghiệm về kỹ thuật phẫu thuật nội soi cắt toàn bộ dạ dày qua 126 bệnh nhân điều trị ung thư dạ dày tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu, các bệnh nhân được phẫu thuật nội soi cắt toàn bộ dạ từ 2014 đến 05/2021. Kết quả: Có 126 bệnh nhân, tuổi trung bình 60,6 ± 11,1 tuổi. 15,9% ung thư 1/3 trên dạ dày và 81,7% là 1/3 giữa. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. 71,4% PTNS hoàn toàn cắt TBDD và nối lưu thông tiêu hóa bằng máy cắt nối thẳng. 3,2% trường hợp có tai biến trong mổ và 2,4% có biến chứng sau mổ, không có trường hợp nào tử vong. Số hạch nạo vét được trung bình 22,06 ± 7,6 hạch, lượng máu mất trung bình là 32,14 ± 10,4 ml, thời gian phẫu thuật trung bình là 210,4 ± 34,3 phút, thời gian nằm viện trung bình là 8,3 ± 2,5 ngày và thời gian sống thêm toàn bộ sau mổ trung bình là 36,9 ± 2,25 tháng. Kết luận: PTNS cắt TBDD là kỹ thuật an toàn và hiệu quả trong điều trị UTDD, nối thực quản hỗng tràng bằng máy cắt nối thẳng không cắt thực quản và hỗng tràng trước là kỹ thuật an toàn, tiết kiệm. Từ khóa: Kỹ thuật phẫu thuật nội soi dạ dày, ung thư dạ dày. ABSTRACT EXPERIENCE IN 126 PATIENTS OF LAPAROSCOPIC TOTAL GASTRECTOMY FOR THE TREATMENT OF GASTRIC CANCER Background: The goal of this study was to report on the experience of laparoscopic total gastrectomy (LTG) in 126 patients with gastric cancer Materials and Methods: Retrospective descriptive study of 126 patients who underwent LTG for gastric cancer between 2014 and May 2021. Results: Mean age 60,6 ± 11,1; gastric cancer at stage I, II, III was 19,0%, 49,2%, 31,7% respectively. 71,4% patients underwent totally LTG and functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum. 3.2% of cases had complications during surgery and 2,4% of cases had complications after surgery. There was no postoperative deaths. The average number of dredged lymph nodes was 22.06 ± 7.6 lymph nodes. The mean blood loss was 32.14 ± 10.4 ml. The mean operative time was 210.4 ± 34.3 minutes. The mean time for beginning oral feeding was 4.4 ± 1.9 days. The mean hospital stay was 8.3 ± 2.5 days. The mean overall survival was 36.9 ± 2,25 months. Conclusions: LTG is a safe and effective technique for the treatment of gastric cancer. The technique functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum was safe and saving. Keywords: Technique of laparoscopic gastrectomy, gastric cancer

ASO Author Reflections: Anastomotic Complications are More Prevalent in Laparoscopic Total Gastrectomy than in Open Total Gastrectomy

2019 ◽  
Vol 27 (2) ◽  
pp. 527-528
Author(s):  
Takashi Sakamoto ◽  
Michimasa Fujiogi ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Hideo Yasunaga
Keyword(s):  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Anastomotic Complications ◽  
Open Total Gastrectomy

Laparoscopic total gastrectomy with D1+ lymph nodes dissection for a patient with early gastric cancer in Saudi Arabia

2019 ◽  
Vol 4 (1) ◽  
pp. 60
Author(s):  
SaeedJaafar Alshomimi ◽  
SarahHussain Aldubaisi ◽  
SarahHabeeb Alkhardawi ◽  
AbdulrahmanMohammed Abduljabbar
Keyword(s):  
Gastric Cancer ◽  
Saudi Arabia ◽  
Early Gastric Cancer ◽  
Lymph Nodes ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Lymph Nodes Dissection

Laparoscopic total gastrectomy versus open total gastrectomy for cancer: a systematic review and meta-analysis

2012 ◽  
Vol 27 (5) ◽  
pp. 1509-1520 ◽  
Author(s):  
Leonie Haverkamp ◽  
Teus J. Weijs ◽  
Pieter C. van der Sluis ◽  
Ingeborg van der Tweel ◽  
Jelle P. Ruurda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Gastrectomy ◽  
Meta Analysis ◽  
Laparoscopic Total Gastrectomy ◽  
Open Total Gastrectomy

Comparison of Percutaneous versus Open Surgical techniques for placement of Peritoneal Dialysis Catheters

JMS SKIMS ◽  
2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Imtiyaz Ahmad Wani ◽  
Rayees Yousuf Sheikh ◽  
Muzafar Masood Wani ◽  
Arif Hamid ◽  
Gh Mohammad Bhat ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Surgical Technique ◽  
Hospital Stay ◽  
Surgical Techniques ◽  
Invasive Technique ◽  
Surgical Morbidity ◽  
Non Invasive ◽  
Laparoscopic Techniques ◽  
Access Technique ◽  
Mini Laparotomy

Background: Nephrologists have used percutaneous placements of peritoneal dialysis catheters (PDCs) with or without fluoroscopic guidance. PDCs are also placed using mini-laparotomy and laparoscopic techniques by surgeons. Percutaneous PDC placement by nephrologists is a simple, non-invasive technique with minimum intraoperative morbidity. We compared operative and immediate complications of PDCs using percutaneous versus open surgical mode of insertion. Methods: Data of all patients entering into CAPD programme in our center between July 2011 to July 2015 was collected. A total of 377 PDCs had been inserted over 48 months in 358 patients. Of 377 catheters inserted, 224 had been inserted by percutaneous method and 153 by surgical technique. Results: Wound hematoma developed in 3.5% of percutaneously placed catheters vs 2.6% of catheters placed by surgical technique, p-0.061. Haemorrhagic effluent was seen in 4.46% of percutaneously placed catheters vs 3.92% of surgically placed catheters, p-0.068. Bowel injury occurred in 1.33% of percutaneously placed catheters vs 0.65% of surgically placed catheters, p-0159. Dialysate leak occurred in 2.6% of catheters placed percutaneously vs 6.5% of catheters placed by surgical technique, p-0.068. Percutaneous PDC allowed a significantly shorter hospital stay, smaller wound size and less break-in period Conclusions: Percutaneously placed CAPD catheters by nephrologists ensues significantly less hospital stay, small sized incision, lesser break-in period and less post-surgical morbidity as compared with surgically placed catheters. Percutaneous PDC placement is minimally invasive, safe, less time consuming and dependable peritoneal access technique.

scholarly journals Modified π-shaped Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: a Report of 40 Consecutive Cases From a Single Center

2021 ◽  
Author(s):  
Jiadi Xing ◽  
Kai Xu ◽  
Maoxing Liu ◽  
Pin Gao ◽  
Fei Tan ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Gastrectomy ◽  
Surgical Outcomes ◽  
Operative Time ◽  
Tumor Location ◽  
Laparoscopic Total Gastrectomy ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

Abstract Background: Intracorporeal esophagojejunostomy remains a challenging technique in totally laparoscopic total gastrectomy (TLTG) without established standard anastomosis method. π-shaped esophagojejunostomy in TLTG was reported to be safe and feasible. Therefore, this study aimed to depict our modified π-shaped esophagojejunostomy in TLTG and evaluate its short-term surgical outcomes.Methods: From April 2018 to October 2019, 40 patients with gastric cancer who underwent TLTG by the same surgeon with modified π-shaped esophagojejunostomy were enrolled. Clinicopathologic data including age, gender, body mass index, American Society of Anesthesiologists score, tumor size, tumor location, depth of tumor invasion, number of harvested lymph nodes, nodal metastasis and TNM stage, operative time, estimated blood loss, time to resume diet, postoperative hospital stays, complication, and mortality were collected and retrospectively analyzed.Results: The mean operative time and estimated blood loss were 264.6 ± 56.9 min and 68.5 ± 53.3 mL, respectively. Postoperative flatus occurred at 4.6 ± 1.7 days. The mean time to resume diet was 7.4 ± 1.7 days postoperatively. One patient was diagnosed with anastomotic leakage and managed with conservative therapy. Pleural effusion, occurring in 4 (10%) patients, was the most common complication. One patient experienced intra-abdominal bleeding requiring reoperation. Other complications were atrial fibrillation and wound infection. No mortality occurred during the 6-month follow-up.Conclusions: Modified π-shaped esophagojejunostomy is a safe and feasible method for intracorporeal anastomosis in TLTG, which showed favorable surgical outcomes.

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