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Title: Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer.
Authors: Okabe, Hiroshi  KAKEN_id
Obama, Kazutaka  kyouindb  KAKEN_id
Tanaka, Eiji  KAKEN_id
Nomura, Akinari
Kawamura, Jun-ichiro
Nagayama, Satoshi
Itami, Atsushi
Watanabe, Go
Kanaya, Seiichiro
Sakai, Yoshiharu  kyouindb  KAKEN_id
Author's alias: 岡部, 寛
Keywords: Esophagojejunostomy
Gastric cancer
Laparoscopic surgery
Total gastectomy
Issue Date: Sep-2009
Publisher: Springer Verlag
Journal title: Surgical endoscopy
Volume: 23
Issue: 9
Start page: 2167
End page: 2171
Abstract: BACKGROUND: To facilitate acceptance of laparoscopic total gastrectomy (LTG) for patients with upper gastric cancer, a simple, secure technique of reconstruction is necessary. The authors developed a new technique for intracorporeal esophagojejunal anastomosis that does not require hand sewing. METHODS: From September 2006 to January 2008, 16 patients (11 men and 5 women) with gastric cancer underwent LTG at the authors' institution. Laparoscopic esophagojejunal anastomosis using the following method was attempted for all patients. The esophagus was transected while being rotated by about 45 degrees counterclockwise to make the subsequent anastomosis easier. After the Y-anastomosis was created, an endoscopic linear stapler was applied to create a side-to-side anastomosis between the left dorsal side of the esophagus and the jejunal limb. The entry hole was first closed roughly with hernia staplers. Subsequently, an endoscopic linear stapler was applied so that all hernia staplers could be removed and the closure completed. RESULTS: Laparoscopic esophagojejunal anastomosis was successfully performed for 15 patients. Intracorporeal anastomosis failed for one patient because a nasogastric tube was caught between the jaws of an endostapler, which resulted in a conversion to open procedure. No postoperative anastomotic complications occurred. CONCLUSIONS: Using the new technique, intracorporeal linear-stapled esophagojejunal anastomosis can be performed easily and securely. This technique could become one of the standard methods for reconstruction after LTG, facilitating the acceptance of LTG as a surgical option for patients with upper gastric cancer.
Rights: c Springer Science+Business Media, LLC 2008
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/2433/93003
DOI(Published Version): 10.1007/s00464-008-9987-8
PubMed ID: 18553203
Appears in Collections:Journal Articles

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