Objective To investigate the feasibility and safety of clinical application of delta-shaped esophagojejunostomy using overlap method in laparoscopic total gastrectomy and proximal gastrectomy for gastric cancer. Methods The clinical data of 9 patients with gastric cancer who underwent laparoscopic radical gastrectomy from October 2017 to March 2018 was retrospectively analyzed. There were 4 cases with proximal gastric cancer using laparoscopic radical proximal gastrectomy with double-tract reconstruction and 5 cases including 1 case with proximal gastric cancer and 4 cases with middle third gastric cancer using laparoscopic total gastrectomy with Roux-en-Y reconstruction. All cases underwent delta-shaped esophagojejunostomy using modified overlap method. Results All delta-shaped esophagojejunostomy using overlap method was performed successfully. Total operative time was(273.9±; 48.2) min and the time for delta-shaped overlap esophagojejunostomy was (40.9±; 13.3) min. Intraoperative blood loss was (58.9±; 43.4) mL and the mean lymph nodes harvested was 27.1±; 11.8. The microscopic resection margin was cancer-free in all 9 cases. The time to first postoperative flatus and liquid diet was (2.5±; 0.9) d and (4.8±; 1.3) d, respectively. Postoperative hospital stay was (7.9±; 1.8) d. No postoperative complication was found in all cases. Conclusion Delta-shaped esophagojejunostomy using modified overlap method in laparoscopic total gastrectomy and proximal gastrectomy for gastric cancer would be feasible and safe, and deserves clinical practice.
YAN Chao, LIU Wentao, YANG Zhongyin, NI Zhentian, XU Wei, LI Chen, YAN Min, ZHU Zhenggang
. Clinical efficacy of delta-shaped esophagojejunostomy using overlap method in laparoscopic total gastrectomy and proximal gastrectomy for gastric cancer[J]. Journal of Surgery Concepts & Practice, 2018
, 23(05)
: 430
-436
.
DOI: 10.16139/j.1007-9610.2018.05.011
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