Progression from laparoscopic-assisted to totally laparoscopic distal gastrectomy: comparison of circular stapler (i-DST) and linear stapler (BBT) for intracorporeal anastomosis.
Progression from laparoscopic-assisted to totally laparoscopic distal gastrectomy: comparison of circular stapler (i-DST) and linear stapler (BBT) for intracorporeal anastomosis.
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DOI：
10.1007/s00464-012-2433-y
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发表时间：
2013-01
影响因子：
3.1
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Ikeda, Tetsuo;Kawano, Hiroyuki;Hisamatsu, Yuichi;Ando, Koji;Saeki, Hiroshi;Oki, Eiji;Ohga, Takefumi;Kakeji, Yoshihiro;Tsujitani, Shunichi;Kohnoe, Shunji;Maehara, Yoshihiko
关键词：
Billroth I（B-I）胃十二指肠吻合术是一种吻合术，广泛用于远端胃癌的胃切除术后。圆形吻合器常用于开放式和腹腔镜辅助远端胃切除术中的B-I胃十二指肠吻合术。最近，完全腹腔镜远端胃切除术（TLDG）被认为比腹腔镜辅助胃切除术创伤更小，许多进行腹腔镜辅助远端胃切除术的机构正在尝试在不显著改变吻合方法的情况下发展到TLDG。本报告的目的是介绍使用环形或直线型吻合器行结肠内胃十二指肠吻合术的新方法的技术细节，并评价其技术可行性和安全性。2010年2月至2011年4月期间，17名使用圆形吻合器（n = 7）或直线型吻合器（n = 10）采用腔内双吻合技术（BBT）进行TLDG的患者入组本研究。分析临床病理资料、手术资料和术后结果。17例患者均无术中并发症或转为开放手术。胃十二指肠吻合术后常见的并发症，如吻合口瘘和狭窄，没有观察到。使用DST（64 ± 24 min）完成吻合所需时间显著长于使用BBT（34 ± 7 min），但使用BBT需要的吻合器钉仓多于DST。使用环形或直线型吻合器进行TLDG是可行且安全的。DST将使使用环形吻合器进行腹腔镜辅助远端胃切除术的机构顺利进展到TLDG，并且这种进展可能更经济，因为手术期间使用的吻合器钉仓更少。但是，如果一家机构已经在TLDG中进行δ吻合，但在δ吻合方面遇到了某些问题，则从δ吻合转换为BBT应该是有益的。本文的在线版本（doi：10.1007/s 00464 -012-2433-y）包含补充材料，可供授权用户使用。
Billroth I (B-I) gastroduodenostomy is an anastomotic procedure that is widely performed after gastric resection for distal gastric cancer. A circular stapler often is used for B-I gastroduodenostomy in open and laparoscopic-assisted distal gastrectomy. Recently, totally laparoscopic distal gastrectomy (TLDG) has been considered less invasive than laparoscopic-assisted gastrectomy, and many institutions performing laparoscopic-assisted distal gastrectomy are trying to progress to TLDG without markedly changing the anastomosis method. The purpose of this report is to introduce the technical details of new methods of intracorporeal gastroduodenostomy using either a circular or linear stapler and to evaluate their technical feasibility and safety. Seventeen patients who underwent TLDG with the intracorporeal double-stapling technique using a circular stapler (n = 7) or the book-binding technique (BBT) using a linear stapler (n = 10) between February 2010 and April 2011 were enrolled in the study. Clinicopathological data, surgical data, and postoperative outcomes were analyzed. There were no intraoperative complications or conversions to open surgery in any of the 17 patients. The usual postoperative complications following gastroduodenostomy, such as anastomotic leakage and stenosis, were not observed. Anastomosis took significantly longer to complete with DST (64 ± 24 min) than with BBT (34 ± 7 min), but more stapler cartridges were needed with BBT than with DST. TLDG using a circular or linear stapler is feasible and safe to perform. DST will enable institutions performing laparoscopic-assisted distal gastrectomy with circular staplers to progress to TLDG without problems, and this progression may be more economical because fewer stapler cartridges are used during surgery. However, if an institution has already been performing δ anastomosis in TLDG but has been experiencing certain issues with δ anastomosis, converting from δ anastomosis to BBT should be beneficial. The online version of this article (doi:10.1007/s00464-012-2433-y) contains supplementary material, which is available to authorized users.
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影响因子：
9
作者：
Adachi, Y;Suematsu, T;Akazawa, K
通讯作者：
Akazawa, K
影响因子：
3.2
作者：
Hiki, Naoki;Fukunaga, Testsu;Yamaguchi, Toshiharu
通讯作者：
Yamaguchi, Toshiharu
DOI：
10.1097/sle.0b013e3181b6c867
发表时间：
2009-10-01
期刊：
Surgical laparoscopy, endoscopy & percutaneous techniques
影响因子：
--
作者：
Ichikawa, Daisuke;Kubota, Takeshi;Otsuji, Eigo
通讯作者：
Otsuji, Eigo
DOI：
10.1007/s00464-007-9446-y
发表时间：
2008-02-01
影响因子：
3.1
作者：
Kim, Jin-Jo;Song, Kyo Young;Park, Seung Man
通讯作者：
Park, Seung Man
影响因子：
5.2
作者：
Mayers, TM;Orebaugh, MG
通讯作者：
Orebaugh, MG