Lee Ji-Eun, Kim Ki Hyun, Seo Kyung Won
Department of Surgery, Kosin University College of Medicine, Busan, Korea.
J Minim Invasive Surg. 2020 Mar 15;23(1):17-21. doi: 10.7602/jmis.2020.23.1.17.
This study evaluated the safety and efficacy of totally laparoscopic total gastrectomy (TLTG) with esophagojejunostomy by comparing left dorsal wall anastomosis (LDA) with parallel-line anastomosis (PA) methods.
We retrospectively reviewed 28 patients who underwent laparoscopic total gastrectomy (LTG) for gastric cancer from January 2017 to September 2018. The patients were divided into two groups according to type of operation: 15 patients underwent PA and 13 underwent LDA. Clinico-pathologic characteristics and surgical outcomes in the two groups were compared and analyzed.
Surgical outcomes of estimated blood loss, operation time, and length of postoperative stay were similar between the two groups. In addition, there was no statistical difference in total operation time (186.5±37.0 min vs. 209.0±36.9 min, =0.121) between the two groups. However, compared with the PA group, the LDA group required fewer additional stitches for reinforcement (=0.002).
Intracorporeal reconstruction of esophagojejunostomy using an LDA method may be a feasible and easy technique for TLTG compared with the PA method. Additional studies with larger sample sizes are needed to further support these results.
本研究通过比较左后壁吻合术(LDA)与平行线吻合术(PA),评估完全腹腔镜全胃切除术(TLTG)联合食管空肠吻合术的安全性和有效性。
我们回顾性分析了2017年1月至2018年9月期间接受腹腔镜全胃切除术(LTG)治疗胃癌的28例患者。根据手术方式将患者分为两组:15例行PA,13例行LDA。比较并分析两组的临床病理特征和手术结果。
两组的估计失血量、手术时间和术后住院时间等手术结果相似。此外,两组的总手术时间(186.5±37.0分钟对209.0±36.9分钟,P = 0.121)无统计学差异。然而,与PA组相比,LDA组加固所需的额外缝线较少(P = 0.002)。
与PA方法相比,使用LDA方法进行食管空肠吻合的体内重建可能是一种可行且简便的TLTG技术。需要更多样本量的进一步研究来支持这些结果。