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Title: Laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis using a knifeless endoscopic linear stapler.
Authors: Okabe, Hiroshi
Obama, Kazutaka  kyouindb  KAKEN_id
Tanaka, Eiji
Tsunoda, Shigeru  kyouindb  KAKEN_id
Akagami, Masatoshi
Sakai, Yoshiharu  kyouindb  KAKEN_id
Author's alias: 岡部, 寛
Keywords: Laparoscopic surgery
Gastric cancer
Esophago-gastric anastomosis
Proximal gastrectomy
Issue Date: Apr-2013
Publisher: Springer Japan
Journal title: Gastric cancer
Volume: 16
Issue: 2
Start page: 268
End page: 274
Abstract: Proximal gastrectomy has been applied for selected patients with early upper gastric cancer, because of its potential advantages over total gastrectomy, such as preserving gastric capacity and entailing fewer hormonal and nutritional deficiencies. Esophago-gastric anastomosis is a simple reconstruction method with an excellent postoperative outcome provided that gastroesophageal reflux is properly prevented. Following open surgery, the esophagus is anastomosed to the anterior stomach wall with partial fundoplication to prevent esophageal reflux. We developed a novel laparoscopic hand-sewn method to reproduce the anti-reflux procedure that is used in open surgery. The esophagus is first fixed to the anterior stomach wall with a knifeless endoscopic linear stapler. This fixation contributes to maintaining a stable field for easier hand-sewn anastomosis, and allows us to complete the left side of the fundoplication at the same time. This novel technique was used to successfully perform complete laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis in ten patients, without any postoperative complications. No patient had symptoms of gastroesophageal reflux during a median follow-up period of 19.9 months. One patient developed anastomotic stenosis, and this was resolved with endoscopic dilatation. The mean percent body weight loss at 12 months after surgery, in comparison to the preoperative weight, was 10.4 %. Laparoscopic proximal gastrectomy with an esophago-gastric anastomosis using our novel technique would be a feasible choice would be a feasible choice and would show benefit for selected patients with early upper gastric cancer.
Rights: The final publication is available at Springer via http://dx.doi.org/10.1007/s10120-012-0181-2
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
URI: http://hdl.handle.net/2433/189749
DOI(Published Version): 10.1007/s10120-012-0181-2
PubMed ID: 22825361
Appears in Collections:Journal Articles

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