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dc.contributor.authorOkabe, Hiroshija
dc.contributor.authorObama, Kazutakaja
dc.contributor.authorTanaka, Eijija
dc.contributor.authorTsunoda, Shigeruja
dc.contributor.authorAkagami, Masatoshija
dc.contributor.authorSakai, Yoshiharuja
dc.contributor.alternative岡部, 寛ja
dc.date.accessioned2014-09-22T00:34:04Z-
dc.date.available2014-09-22T00:34:04Z-
dc.date.issued2013-04ja
dc.identifier.issn1436-3291ja
dc.identifier.urihttp://hdl.handle.net/2433/189749-
dc.description.abstractProximal 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.ja
dc.format.mimetypeapplication/pdfja
dc.language.isoengja
dc.publisherSpringer Japanja
dc.rightsThe final publication is available at Springer via http://dx.doi.org/10.1007/s10120-012-0181-2ja
dc.rights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.ja
dc.subjectLaparoscopic surgeryja
dc.subjectGastric cancerja
dc.subjectEsophago-gastric anastomosisja
dc.subjectProximal gastrectomyja
dc.subject.meshAdultja
dc.subject.meshAgedja
dc.subject.meshAged, 80 and overja
dc.subject.meshAnastomosis, Surgical/instrumentationja
dc.subject.meshAnastomosis, Surgical/methodsja
dc.subject.meshEsophagus/surgeryja
dc.subject.meshFemaleja
dc.subject.meshGastrectomy/methodsja
dc.subject.meshHumansja
dc.subject.meshIntraoperative Periodja
dc.subject.meshLaparoscopy/methodsja
dc.subject.meshMaleja
dc.subject.meshMiddle Agedja
dc.subject.meshPostoperative Complications/prevention & controlja
dc.subject.meshStomach Neoplasms/surgeryja
dc.subject.meshSurgical Stapling/instrumentationja
dc.subject.meshSurgical Stapling/methodsja
dc.subject.meshTreatment Outcomeja
dc.titleLaparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis using a knifeless endoscopic linear stapler.ja
dc.type.niitypeJournal Articleja
dc.identifier.jtitleGastric cancerja
dc.identifier.volume16ja
dc.identifier.issue2ja
dc.identifier.spage268ja
dc.identifier.epage274ja
dc.relation.doi10.1007/s10120-012-0181-2ja
dc.textversionauthorja
dc.identifier.pmid22825361ja
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