Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer
Background: Intracorporeal oesophagojejunostomy is one of the key steps in laparoscopic total gastrectomy (LTG). At present, there is no widely accepted anastomosis technique in oesophagojejunostomy. Materials and Methods: We retrospectively studied 63 patients with gastric cancer who underwent LTG....
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
|
| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=1;spage=31;epage=37;aulast=Chen |
| _version_ | 1818977395416236032 |
|---|---|
| author | Cheng Chen Meng Wei Xingbo Feng Haifeng Han Chao Wang Qingsi He Wenbin Yu |
| author_facet | Cheng Chen Meng Wei Xingbo Feng Haifeng Han Chao Wang Qingsi He Wenbin Yu |
| author_sort | Cheng Chen |
| collection | DOAJ |
| description | Background: Intracorporeal oesophagojejunostomy is one of the key steps in laparoscopic total gastrectomy (LTG). At present, there is no widely accepted anastomosis technique in oesophagojejunostomy.
Materials and Methods: We retrospectively studied 63 patients with gastric cancer who underwent LTG. Two types of anastomosis techniques have been applied during LTG: the reverse puncture device (RPD) (28 patients) and overlap (35 patients).
Results: A total of 63 patients (51 males and 12 females: mean age = 58 years and mean body mass index [BMI] = 26.3 kg/m2) were enrolled in this study. There were no significant difference in age, BMI, duration of surgery, duration of anastomosis, blood loss, post-operative hospital stay, tumour location, tumour size, degree of tumour differentiation, Borrmann type, total number of lymph nodes, number of positive lymph nodes, hospital stay, hospitalisation costs, intra-operative complications, post-operative complications and prognosis between the RPD group and the overlap group. RPD group showed a significant advantage in terms of the distance between the top border of tumours and the top resection margin (P < 0.001). We further found that the oesophageal lateral negative surgical margin distance of the upper gastric cancer in the RPD group was significantly longer than that in the overlap group (P < 0.001).
Conclusions: Both the RPD and overlap techniques are safe and applicable in LTG. However, RPD has the advantage of obtaining an adequate safe margin compared with that of overlap technique, especially in patients with gastro-oesophageal junction carcinoma. |
| first_indexed | 2024-12-20T16:27:04Z |
| format | Article |
| id | doaj.art-e5824cf350a347189e85c165f4f167ef |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-20T16:27:04Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-e5824cf350a347189e85c165f4f167ef2022-12-21T19:33:22ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212022-01-01181313710.4103/jmas.JMAS_276_19Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancerCheng ChenMeng WeiXingbo FengHaifeng HanChao WangQingsi HeWenbin YuBackground: Intracorporeal oesophagojejunostomy is one of the key steps in laparoscopic total gastrectomy (LTG). At present, there is no widely accepted anastomosis technique in oesophagojejunostomy. Materials and Methods: We retrospectively studied 63 patients with gastric cancer who underwent LTG. Two types of anastomosis techniques have been applied during LTG: the reverse puncture device (RPD) (28 patients) and overlap (35 patients). Results: A total of 63 patients (51 males and 12 females: mean age = 58 years and mean body mass index [BMI] = 26.3 kg/m2) were enrolled in this study. There were no significant difference in age, BMI, duration of surgery, duration of anastomosis, blood loss, post-operative hospital stay, tumour location, tumour size, degree of tumour differentiation, Borrmann type, total number of lymph nodes, number of positive lymph nodes, hospital stay, hospitalisation costs, intra-operative complications, post-operative complications and prognosis between the RPD group and the overlap group. RPD group showed a significant advantage in terms of the distance between the top border of tumours and the top resection margin (P < 0.001). We further found that the oesophageal lateral negative surgical margin distance of the upper gastric cancer in the RPD group was significantly longer than that in the overlap group (P < 0.001). Conclusions: Both the RPD and overlap techniques are safe and applicable in LTG. However, RPD has the advantage of obtaining an adequate safe margin compared with that of overlap technique, especially in patients with gastro-oesophageal junction carcinoma.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=1;spage=31;epage=37;aulast=Chenanastomosis techniquegastric cancerlaparoscopic total gastrectomyoesophagojejunostomy |
| spellingShingle | Cheng Chen Meng Wei Xingbo Feng Haifeng Han Chao Wang Qingsi He Wenbin Yu Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer Journal of Minimal Access Surgery anastomosis technique gastric cancer laparoscopic total gastrectomy oesophagojejunostomy |
| title | Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| title_full | Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| title_fullStr | Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| title_full_unstemmed | Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| title_short | Comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| title_sort | comparison of reverse puncture device and overlap in laparoscopic total gastrectomy for gastric cancer |
| topic | anastomosis technique gastric cancer laparoscopic total gastrectomy oesophagojejunostomy |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2022;volume=18;issue=1;spage=31;epage=37;aulast=Chen |
| work_keys_str_mv | AT chengchen comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT mengwei comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT xingbofeng comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT haifenghan comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT chaowang comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT qingsihe comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer AT wenbinyu comparisonofreversepuncturedeviceandoverlapinlaparoscopictotalgastrectomyforgastriccancer |