Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes (original) (raw)

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  1. Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5:1–5
    Article PubMed Google Scholar
  2. Shinohara T, Sonoda T, Niki M, Nomura E, Nishiguchi K, Tanigawa N (2003) Laparoscopically-assisted pylorus-preserving gastrectomy with preservation of the vagus nerve. Eur J Surg 169(1):55–58
    Google Scholar
  3. Ishikawa K, Arita T, Ninomiya S, Bandoh T, Shiraishi N, Kitano S (2007) Outcome of segmental gastrectomy versus distal gastrectomy for early gastric cancer. World J Surg 31:2204–2207
    Article PubMed Google Scholar
  4. Shinohara T, Oihyama S, Muto T, Kato Y, Yanaga K, Yamaguchi T (2006) Clinical outcome of high segmental gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg 93:975–980
    Article CAS PubMed Google Scholar
  5. Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, Chin HM, Hur H (2008) Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy? Prospective multicentre study. J Gastrointest Surg 12(6):1015–1021
    Article PubMed Google Scholar
  6. Kitagawa Y, Fujii H, Kumai K, Kubota T, Otani Y, Saikawa Y, Yoshida M, Kubo A, Kitajima M (2005) Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management. J Surg Oncol 90(3):147–152
    Article PubMed Google Scholar
  7. Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, Wada Y, Ohtoshi M (2002) Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intra-abdominal gastroduodenostomy. J Am Coll Surg 195(2):284–287
    Article PubMed Google Scholar
  8. Takaori K, Nomura E, Mabuchi H, Lee S, Agui T, Miyamoto Y, Iwamoto M, Watanabe H, Tanigawa N (2005) A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy. Am J Surg 189:178–183
    Article PubMed Google Scholar
  9. Morita S, Katai H, Saka M, Fukagawa T, Sano T, Sasako M (2008) Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg 95:1131–1135
    Article CAS PubMed Google Scholar

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Disclosures

Sang-Woong Lee, George Bouras, Eiji Nomura, Ryoji Yoshinaka, Takaya Tokuhara, Toshikatsu Nitta, Soichiro Tsunemi, and Nobuhiko Tanigawa have no conflicts of interest or financial ties to disclose in relation to this article.

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Authors and Affiliations

  1. Department of General and Gastrointestinal Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
    Sang-Woong Lee, George Bouras, Eiji Nomura, Ryoji Yoshinaka, Takaya Tokuhara, Toshikatsu Nitta, Soichiro Tsunemi & Nobuhiko Tanigawa

Authors

  1. Sang-Woong Lee
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  2. George Bouras
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  3. Eiji Nomura
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  4. Ryoji Yoshinaka
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  5. Takaya Tokuhara
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  6. Toshikatsu Nitta
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  7. Soichiro Tsunemi
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  8. Nobuhiko Tanigawa
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Corresponding author

Correspondence toSang-Woong Lee.

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Lee, SW., Bouras, G., Nomura, E. et al. Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes.Surg Endosc 24, 1774–1780 (2010). https://doi.org/10.1007/s00464-009-0803-x

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