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Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy

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Abstract

Background

Recently, novel intracorporeal esophagojejunostomy using a linear stapler after laparoscopic total gastrectomy (LTG) was reported and termed as the overlap method. In this study, we evaluated the feasibility and safety of the overlap method for esophagojejunostomy or esophagogastrostomy after LTG or laparoscopic proximal gastrectomy (LPG), respectively.

Methods

Twenty-five patients underwent anastomosis using a linear stapler during esophagojejunostomy and esophagogastrostomy after LTG and LPG, respectively. Clinicopathological data and surgical outcomes were evaluated.

Results

The average surgical duration for LTG was 236.8 min compared with 224.1 min for LPG. Postoperative complications were observed in four patients (16.0%); these included a wound infection, an intestinal obstruction, an afferent loop syndrome, and a reflux symptom. The average postoperative hospital stay of the patients was 12.5 days. There was no case of conversion to open surgery, anastomotic leakage or stenosis, or mortality.

Conclusions

The overlap method for esophagojejunostomy or esophagogastrostomy after LTG or LPG is safe and feasible and does not require an additional minilaparotomy, which may result in less pain and favorable cosmetic outcomes.

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References

  1. Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted billroth I gastrectomy. Surg Laparosc Endosc 4(2):146–148

    PubMed  CAS  Google Scholar 

  2. 10th nationwide survey of endoscopic surgery in Japan (2010). J Jpn Soc Endosc Surg 15 (5):565-679

    Google Scholar 

  3. Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23(11):2624–2630. doi:10.1007/s00464-009-0461-z

    Article  PubMed  Google Scholar 

  4. Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197(1):e13–17. doi:10.1016/j.amjsurg.2008.04.019

    Article  PubMed  Google Scholar 

  5. Kim YW, Han HS, Fleischer GD (2003) Hand-assisted laparoscopic total gastrectomy. Surg Laparosc Endosc Percutan Tech 13(1):26–30

    Article  PubMed  Google Scholar 

  6. Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Endosc 16(3):540–544. doi:10.1007/s00464-001-8219-2

    Article  PubMed  CAS  Google Scholar 

  7. Hiki N, Kaminishi M (2005) Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches. Langenbecks Arch Surg 390(5):442–447. doi:10.1007/s00423-005-0573-4

    Article  PubMed  Google Scholar 

  8. Meyer L, Meyer F, Dralle H, Ernst M, Lippert H, Gastinger I (2005) Insufficiency risk of esophagojejunal anastomosis after total abdominal gastrectomy for gastric carcinoma. Langenbecks Arch Surg 390(6):510–516. doi:10.1007/s00423-005-0575-2

    Article  PubMed  CAS  Google Scholar 

  9. Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, Uyama I (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211(6):e25–29. doi:S1072-7515(10)01072-0

    Article  PubMed  Google Scholar 

  10. Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer 1(1):10–24. doi:10.1007/s101209800016

    Article  PubMed  Google Scholar 

  11. Tsujimoto H, Sugasawa H, Ono S, Ichikura T, Yamamoto J, Hase K (2010) Has the accuracy of preoperative diagnosis improved in cases of early-stage gastric cancer? World J Surg 34(8):1840–1846. doi:10.1007/s00268-010-0587-0

    Article  PubMed  Google Scholar 

  12. Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5(1):1–5

    Article  PubMed  Google Scholar 

  13. Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2(4):230–234. doi:10.1007/s101209900041

    Article  PubMed  Google Scholar 

  14. Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, Hirai K, Watanabe M (2009) Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg 209(3):344–351. doi:S1072-7515(09)00410-4

    Article  PubMed  Google Scholar 

  15. Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y (2009) Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 23(9):2167–2171. doi:10.1007/s00464-008-9987-8

    Article  PubMed  Google Scholar 

  16. Okabe H, Satoh S, Inoue H, Kondo M, Kawamura J, Nomura A, Nagayama S, Hasegawa S, Itami A, Watanabe G, Sakai Y (2007) Esophagojejunostomy through minilaparotomy after laparoscopic total gastrectomy. Gastric Cancer 10(3):176–180. doi:10.1007/s10120-007-0432-9

    Article  PubMed  Google Scholar 

  17. Ziqiang W, ZhiMin C, Jun C, Xiao L, Huaxing L, PeiWu Y (2008) A modified method of laparoscopic side-to-side esophagojejunal anastomosis: report of 14 cases. Surg Endosc 22(9):2091–2094. doi:10.1007/s00464-008-9744-z

    Article  PubMed  Google Scholar 

  18. Bracale U, Marzano E, Nastro P, Barone M, Cuccurullo D, Cutini G, Corcione F, Pignata G (2010) Side-to-side esophagojejunostomy during totally laparoscopic total gastrectomy for malignant disease: a multicenter study. Surg Endosc 24(10):2475–2479. doi:10.1007/s00464-010-0988-z

    Article  PubMed  Google Scholar 

  19. Kinoshita T, Oshiro T, Ito K, Shibasaki H, Okazumi S, Katoh R (2010) Intracorporeal circular-stapled esophagojejunostomy using hand-sewn purse-string suture after laparoscopic total gastrectomy. Surg Endosc 24(11):2908–2912. doi:10.1007/s00464-010-1041-y

    Article  PubMed  Google Scholar 

  20. Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11(4):233–237. doi:10.1007/s10120-008-0481-8

    Article  PubMed  Google Scholar 

  21. Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, Seto Y, Muto T (2007) Laparoscopic esophagogastric circular stapled anastomosis: a modified technique to protect the esophagus. Gastric Cancer 10(3):181–186. doi:10.1007/s10120-007-0433-8

    Article  PubMed  Google Scholar 

  22. Lee SE, Ryu KW, Nam BH, Lee JH, Kim YW, Yu JS, Cho SJ, Lee JY, Kim CG, Choi IJ, Kook MC, Park SR, Kim MJ, Lee JS (2009) Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy. J Surg Oncol 100(5):392–395. doi:10.1002/jso.21345

    Article  PubMed  Google Scholar 

  23. Tonouchi H, Mohri Y, Tanaka K, Kobayashi M, Kusunoki M (2006) Hemidouble stapling for esophagogastrostomy during laparoscopically assisted proximal gastrectomy. Surg Laparosc Endosc Percutan Tech 16(4):242–244. doi:00129689-200608000-00009[pii]

    Article  PubMed  Google Scholar 

  24. Usui S, Inoue H, Yoshida T, Fukami N, Kudo SE, Iwai T (2003) Hand-assisted laparoscopic total gastrectomy for early gastric cancer. Surg Laparosc Endosc Percutan Tech 13(5):304–307

    Article  PubMed  Google Scholar 

  25. Hao YX, Zhong H, Yu PW, Qian F, Zhao YL, Shi Y, Tang B (2010) Influence of laparoscopic gastrectomy on the detection rate of free gastric cancer cells in the peritoneal cavity. Ann Surg Oncol 17(1):65–72. doi:10.1245/s10434-009-0703-2

    Article  PubMed  CAS  Google Scholar 

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All authors certify that they have no commercial associations that might pose a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Hironori Tsujimoto, Yoshihisa Yaguchi, Isao Kumano, Risa Takahata, Yusuke Matsumoto, Kazumichi Yoshida, Hiroyuki Horiguchi, Suefumi Aosasa, Satoshi Ono, Junji Yamamoto & Kazuo Hase

  2. Department of Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan

    Ichiro Uyama

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  1. Hironori Tsujimoto
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  2. Ichiro Uyama
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  12. Kazuo Hase
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Correspondence to Hironori Tsujimoto.

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Tsujimoto, H., Uyama, I., Yaguchi, Y. et al. Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy. Langenbecks Arch Surg 397, 833–840 (2012). https://doi.org/10.1007/s00423-012-0939-3

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  • DOI: https://doi.org/10.1007/s00423-012-0939-3

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