Intra-corporeal hand-sewn esophagojejunostomy is a safe and feasible procedure for totally laparoscopic total gastrectomy: short-term outcomes in 100 consecutive patients
An optimal method for intracorporeal esophagojejunostomy has not yet been standardized. This study sought to introduce intracorporeal hand-sewn end-to-side esophagojejunostomy after totally laparoscopic total gastrectomy.
The author conducted a consecutive series of 100 intracorporeal hand-sewn esophagojejunostomies after totally laparoscopic total gastrectomy for upper third gastric cancer from September 2012 to December 2016.
All patients were successfully operated on without conversion to open- or laparoscope-assisted surgery. The mean reconstruction time was 45 min, and the time until first flatus was 4 days. The time to start a soft diet was 7 days. The length of postoperative hospital stay was 8 days. The overall postoperative morbidity was 8%, including one anastomotic leak, and the mortality was zero. The median follow-up duration was 13 months; no anastomotic strictures were encountered.
Intracorporeal hand-sewn end-to-side esophagojejunostomy after totally laparoscopic total gastrectomy is a safe and feasible procedure. This method can identify negative margins with intraoperative frozen sections before reconstruction and could be a good option for performing intracorporeal esophagojejunostomy with an advanced endoscopic suture technique.
KeywordsLaparoscopy Esophagojejunostomy Hand sewn
This study was supported by Project Grants of Zhejiang Provincial Department of health (Grant No. Y2015ZDA019) and Natural Science Foundation of Zhejiang Province (Grant No. Y15H160027 and No. Y15H160030). We appreciate the voice work for video by Alex Blair who worked at the department of HPB surgery, Johns Hopkins hospital.
Compliance with ethical standards
Xiaowu Xu, Chaojie Huang, Yiping Mou, Renchao Zhang, Yu Pan, Ke Chen, and Chao Lu have no conflicts of interest or financial ties to disclose.
Supplementary material 1 (MP4 482124 KB)
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