Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes
Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes
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DOI：
10.1007/s00464-009-0803-x
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发表时间：
2010-07-01
影响因子：
3.1
通讯作者：
Tanigawa, Nobuhiko
中科院分区：
文献类型：
--
作者：
Lee, Sang-Woong;Bouras, George;Tanigawa, Nobuhiko
早期胃体癌行有限胃切除术可保留更多残胃，从而获得更好的功能预后。腹腔镜节段性胃切除术适用于无淋巴结受累的胃体部早期胃癌。腹腔镜保留幽门胃切除术是一种特殊类型的节段性切除术，用于治疗下半身病变，并在第6站清除淋巴结。腹腔镜下胃-胃吻合术采用三角形吻合技术，自2008年1月以来，我们共施行了12例腹腔镜下保留幽门的胃切除术和13例腹腔镜下节段性胃切除术。所有手术均在腹腔镜下完成。1例发生轻微吻合口瘘的患者接受保守治疗。所有患者均未发生吻合口出血。1例患者在吻合部位发生狭窄，并通过球囊扩张成功治疗。所有患者均未出现胃潴留，腹腔镜胃大部切除术在技术上是可行的，手术效果可接受。虽然这种切除术对肿瘤结局的影响仍有待进一步评估，腹腔镜节段性胃切除术代表了一种微创有限切除术，最大限度地提高了胃癌手术后生活质量的潜力。
Limited gastrectomy for early gastric body cancers can offer a better functional outcome by preserving more remnant stomach. Intracorporeal stapled techniques result in cosmesis and avoid awkward anastomosis through a minilaparotomy.Laparoscopic segmental gastrectomy is indicated for early gastric cancers of the body of the stomach with no evidence of lymph node involvement. Laparoscopic pylorus-preserving gastrectomy is a specific type of segmental resection for lower-body lesions with dissection of lymph nodes in station 6. Intracorporeal gastrogastric anastomosis is performed by the delta-shaped technique using linear staplers.Since January 2008 we have performed 12 laparoscopic pylorus-preserving gastrectomies and 13 laparoscopic segmental gastrectomies. All procedures were completed by laparoscopy. One patient with minor anastomotic leakage was managed conservatively. Bleeding from the anastomosis was not encountered in any of the patients. One patient developed narrowing at the anastomotic site and was treated successfully by balloon dilatation. There was no stasis encountered in any of the patients.Laparoscopic segmental gastrectomy with acceptable surgical outcomes is technically feasible. Although the impact of such resections on oncological outcomes remains to be further evaluated, laparoscopic segmental gastrectomy represents a minimally invasive limited resection that maximizes the potential for a better quality of life following gastric cancer surgery.