Laparoscopic esophagogastrostomy using a knifeless linear stapler after proximal gastrectomy
- 81 Downloads
Proximal gastrectomy should improve the late postoperative function in patients with gastric cancer located in the upper third of the stomach or esophagogastric junction. However, a standard method of esophagogastrostomy has not been established for improving the postoperative function. To prevent reflux and stenosis following proximal gastrectomy, we introduced a novel esophagogastrostomy method using a knifeless linear stapler. The stapler was inserted into holes created in both the esophagus and remnant stomach and fired proximally. A 1.5-cm incision was made from the edge of the entry hole between the staples. The entry hole was then closed with continuous sutures, and fundoplication was performed by wrapping the remnant stomach. We performed this technique in 12 consecutive patients without observing any anastomosis-related complications. The proportion of weight lost 1 year after surgery was 8.8%. Our surgical procedure might be feasible for treating gastric cancer located in the upper third of the stomach or esophagogastric junction.
KeywordsGastric cancer Esophagogastrostomy Proximal gastrectomy
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest and received no financial support for this study.
All procedures and subsequent analyses were performed with the approval of the Institutional Review Board of Mie University Hospital in Japan (no. 2017-3203). The study was conducted in accordance with the guidelines of the 1975 Declaration of Helsinki. Written informed consent was obtained from all study participants.
- 1.Hinoshita E, Takahashi I, Onohara T, Nishizaki T, Matsusaka T, Wakasugi K, et al. The nutritional advantages of proximal gastrectomy for early gastric cancer. Hepatogastroenterology. 2001;48(41):1513–6.Google Scholar
- 2.Takiguchi N, Takahashi M, Ikeda M, Inagawa S, Ueda S, Nobuoka T, et al. Long-term quality-of-life comparison of total gastrectomy and proximal gastrectomy by postgastrectomy syndrome assessment scale (PGSAS-45): a nationwide multi-institutional study. Gastric Cancer. 2015;18(2):407–16.CrossRefGoogle Scholar
- 11.Association JGC. Japanese classification of gastric carcinoma. 15th ed. Tokyo: Kanehara Publisher; 2017.Google Scholar
- 16.Kikuchi S, Nemoto Y, Katada N, Sakuramoto S, Kobayashi N, Shimao H, et al. Results of follow-up endoscopy in patients who underwent proximal gastrectomy with jejunal interposition for gastric cancer. Hepatogastroenterology. 2007;54(73):304–7.Google Scholar