Tsuchida Kazuhito, Saeki Hiroyuki, Yasukawa Mio, Toda Soji, Kamioka Yuto, Suematsu Hideaki, Numata Koji, Higuchi Akio, Matsukawa Hiroshi, Rino Yasushi, Masuda Munetaka
Dept. of Surgery, Yokohama Minami Kyousai Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2503-2505.
Laparoscopic-assisted total gastrectomy(LATG)has several complications early during the introduction of the procedure, so a careful approach is necessary. In this study, we evaluated short-term outcomes after LATG at our hospital. From 2014 to 2017, 21 patients underwent LATG using ENDO-PSI. A 6-cm midline incision was made at the epigastrium, and the abdominal esophagus was transected using ENDO-PSI. The anvil head was fixed with extracorporeal ligation, and an end loop was added to the proximal side of the first suture. Reconstruction was performed with the Roux-en-Y method. The jejunojejunal anastomosis was performed extracorporeally, and esophagojejunostomy was performed using a circular stapler through the small incision. There were 15 men and 6 women, with a mean age of 74 years. The mean operation time was 296 min, and volume of blood loss was 75 mL. The median fasting period was 3(3-10)days, and the postoperative hospitalization period was 12(8-28)days. The postoperative complications were Grade Ⅱ in 4 patients and Grade Ⅲ in 1 patient. The complication due to esophagojejunostomy was anastomotic leakage in 1 patient, while no anastomotic stenosis was found. LATG using ENDO-PSI can be safely performed.
腹腔镜辅助全胃切除术（LATG）在该手术引入初期有几种早期并发症，因此需要谨慎操作。在本研究中，我们评估了我院LATG后的短期结局。2014年至2017年，21例患者使用ENDO-PSI进行了LATG。在上腹部做一个6厘米的中线切口，使用ENDO-PSI切断腹段食管。钉砧头用体外结扎固定，并在第一针缝线的近端加一个端环。采用Roux-en-Y法进行重建。空肠空肠吻合在体外进行，食管空肠吻合通过小切口使用圆形吻合器进行。男性15例，女性6例，平均年龄74岁。平均手术时间为296分钟，失血量为75毫升。中位禁食期为3（3 - 10）天，术后住院时间为12（8 - 28）天。术后并发症4例为Ⅱ级，1例为Ⅲ级。食管空肠吻合的并发症为1例吻合口漏，未发现吻合口狭窄。使用ENDO-PSI进行LATG可以安全实施。
