Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer
Abstract Background Digestive tract reconstruction in totally laparoscopic total gastrectomy can be divided into two types: instrument anastomosis and hand-sewn anastomosis. This study explored the feasibility and safety of hand-sewn sutures in esophagojejunostomy of totally laparoscopic total gastr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-021-02249-8 |
| _version_ | 1818723924803846144 |
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| author | Zeshen Wang Yuzhe Wei Xirui Liu Zhenglong Li Guanyu Zhu Yanfeng Li Kuan Wang |
| author_facet | Zeshen Wang Yuzhe Wei Xirui Liu Zhenglong Li Guanyu Zhu Yanfeng Li Kuan Wang |
| author_sort | Zeshen Wang |
| collection | DOAJ |
| description | Abstract Background Digestive tract reconstruction in totally laparoscopic total gastrectomy can be divided into two types: instrument anastomosis and hand-sewn anastomosis. This study explored the feasibility and safety of hand-sewn sutures in esophagojejunostomy of totally laparoscopic total gastrectomy, compared with instrument anastomosis using an overlap linear cutter. Methods This retrospective cohort study was conducted from January 2017 to January 2020 at one institution. The clinical data of 50 patients who underwent totally laparoscopic total gastrectomy, with an average follow-up time of 12 months, were collected. The clinicopathologic data, short-term survival prognosis, and results of patients in the hand-sewn anastomosis (n=20) and the overlap anastomosis (n=30) groups were analyzed. Results There were no significant differences between the groups in sex, age, body mass index, American Society of Anesthesiologists score, tumor location, preoperative complications, abdominal operation history, tumor size, pTNM stage, blood loss, first postoperative liquid diet, exhaust time, or postoperative length of hospital stay. The hand-sewn anastomosis group had a significantly prolonged operation time (204±26.72min versus 190±20.90min, p=0.04) and anastomosis time (58±22.0min versus 46±15.97min, p=0.029), and a decreased operation cost (CNY 77,100±1700 versus CNY 71,900±1300, p<0.0001). Postoperative complications (dynamic ileus, abdominal infection, and pancreatic leakage) occurred in three patients (15%) in the hand-sewn anastomosis group and in four patients (13.3%) in the overlap anastomosis group (anastomotic leakage, anastomotic bleeding, dynamic ileus, and duodenal stump leakage). Conclusion The hand-sewn anastomosis method of esophagojejunostomy under totally laparoscopic total gastrectomy is safe and feasible and is an important supplement to linear and circular stapler anastomosis. It may be more convenient regarding obesity, a relatively high position of the anastomosis, edema of the esophageal wall, and short jejunal mesentery. |
| first_indexed | 2024-12-17T21:18:15Z |
| format | Article |
| id | doaj.art-3a722a2a5bb3423b89be47fd49b9b909 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-17T21:18:15Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-3a722a2a5bb3423b89be47fd49b9b9092022-12-21T21:32:17ZengBMCWorld Journal of Surgical Oncology1477-78192021-08-011911910.1186/s12957-021-02249-8Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancerZeshen Wang0Yuzhe Wei1Xirui Liu2Zhenglong Li3Guanyu Zhu4Yanfeng Li5Kuan Wang6Department of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Surgery, Harbin Medical University Cancer HospitalAbstract Background Digestive tract reconstruction in totally laparoscopic total gastrectomy can be divided into two types: instrument anastomosis and hand-sewn anastomosis. This study explored the feasibility and safety of hand-sewn sutures in esophagojejunostomy of totally laparoscopic total gastrectomy, compared with instrument anastomosis using an overlap linear cutter. Methods This retrospective cohort study was conducted from January 2017 to January 2020 at one institution. The clinical data of 50 patients who underwent totally laparoscopic total gastrectomy, with an average follow-up time of 12 months, were collected. The clinicopathologic data, short-term survival prognosis, and results of patients in the hand-sewn anastomosis (n=20) and the overlap anastomosis (n=30) groups were analyzed. Results There were no significant differences between the groups in sex, age, body mass index, American Society of Anesthesiologists score, tumor location, preoperative complications, abdominal operation history, tumor size, pTNM stage, blood loss, first postoperative liquid diet, exhaust time, or postoperative length of hospital stay. The hand-sewn anastomosis group had a significantly prolonged operation time (204±26.72min versus 190±20.90min, p=0.04) and anastomosis time (58±22.0min versus 46±15.97min, p=0.029), and a decreased operation cost (CNY 77,100±1700 versus CNY 71,900±1300, p<0.0001). Postoperative complications (dynamic ileus, abdominal infection, and pancreatic leakage) occurred in three patients (15%) in the hand-sewn anastomosis group and in four patients (13.3%) in the overlap anastomosis group (anastomotic leakage, anastomotic bleeding, dynamic ileus, and duodenal stump leakage). Conclusion The hand-sewn anastomosis method of esophagojejunostomy under totally laparoscopic total gastrectomy is safe and feasible and is an important supplement to linear and circular stapler anastomosis. It may be more convenient regarding obesity, a relatively high position of the anastomosis, edema of the esophageal wall, and short jejunal mesentery.https://doi.org/10.1186/s12957-021-02249-8Gastric cancer; Anastomosissurgical; gastric surgerysuture techniquesdigestive system surgical procedures |
| spellingShingle | Zeshen Wang Yuzhe Wei Xirui Liu Zhenglong Li Guanyu Zhu Yanfeng Li Kuan Wang Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer World Journal of Surgical Oncology Gastric cancer; Anastomosis surgical; gastric surgery suture techniques digestive system surgical procedures |
| title | Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| title_full | Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| title_fullStr | Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| title_full_unstemmed | Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| title_short | Application value of hand-sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| title_sort | application value of hand sewn anastomosis in totally laparoscopic total gastrectomy for gastric cancer |
| topic | Gastric cancer; Anastomosis surgical; gastric surgery suture techniques digestive system surgical procedures |
| url | https://doi.org/10.1186/s12957-021-02249-8 |
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