Usefulness of the Transoral Anvil Delivery System for Esophagojejunostomy After Laparoscopic Total Gastrectomy: A Single-institution Comparative Study of Transoral Anvil Delivery System and the Overlap Method
Usefulness of the Transoral Anvil Delivery System for Esophagojejunostomy After Laparoscopic Total Gastrectomy: A Single-institution Comparative Study of Transoral Anvil Delivery System and the Overlap Method
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DOI：
10.1097/sle.0000000000000495
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发表时间：
2018-04-01
影响因子：
1
通讯作者：
Ishikawa, Daichi
中科院分区：
文献类型：
--
作者：
Yoshikawa, Kozo;Shimada, Mitsuo;Ishikawa, Daichi
目的：腹腔镜全胃切除术（LTG）后的重建技术有很多报道，但目前尚不清楚哪种吻合技术最有用，也没有建立标准方法。本研究探讨是否LTG使用经口钉砧输送系统（TOADS）是一个可行的和安全的程序为gastric cancer.Materials和Methods：一系列的47例患者进行了重叠的方法和36进行了半双吻合技术与TOADS。结果：TOADS组的重建手术时间更短（163 vs. 45 +/-10 min，P=0.003），失血量减少（45 +/- 15 vs. 126 +/-13 mL，P=0.0002）。两组之间的术中并发症、转为开放手术和术中血管狭窄相关并发症无显著差异。此外，并发症，再手术，死亡率和术后住院时间的发生率没有显着差异。结论：LTG使用TOADS胃癌可能是一个技术上可行的手术方法，可接受的发病率。
Purpose:Many reconstruction techniques have been reported after laparoscopic total gastrectomy (LTG), but it is not clear which anastomosis technique is most useful, and no standard methods have been established. This study examined whether LTG using the transoral anvil delivery system (TOADS) is a feasible and safe procedure for gastric cancer.Materials and Methods:A series of 47 patients underwent the overlap method and 36 underwent the hemi-double-stapling technique with TOADS. Intraoperative and postoperative outcomes were compared between the 2 groups.Results:In the TOADS group, operation time for reconstruction was shorter (163 vs. 45 +/- 10min, P=0.003), and blood loss was reduced (45 +/- 15 vs. 126 +/- 13mL, P=0.0002). There were no significant differences in intraoperative complications, conversion to open surgery, and intraoperative anastomosis-related complications between the 2 groups. Furthermore, there were no significant differences in the incidence of complications, reoperation, mortality, and postoperative hospital stay.Conclusion:LTG using TOADS for gastric cancer may be a technically feasible surgical procedure with acceptable morbidity.