A Novel Valvuloplastic Esophagogastrostomy Technique for Laparoscopic Transhiatal Lower Esophagectomy and Proximal Gastrectomy for Siewert Type II Esophagogastric Junction Carcinoma—the Tri Double-Flap Hybrid Method
| العنوان: | A Novel Valvuloplastic Esophagogastrostomy Technique for Laparoscopic Transhiatal Lower Esophagectomy and Proximal Gastrectomy for Siewert Type II Esophagogastric Junction Carcinoma—the Tri Double-Flap Hybrid Method |
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| المؤلفون: | Masayoshi Yasui, Hidenori Takahashi, Takeshi Omori, Masato Sakon, Yoshitomo Yanagimoto, Masayuki Ohue, Hiroshi Wada, Keijirou Sugimura, Masahiko Yano, Naoki Shinno, Hiroshi Miyata, Kazuyoshi Yamamoto |
| المصدر: | Journal of Gastrointestinal Surgery. 25:16-27 |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Laparoscopic surgery, medicine.medical_specialty, Proximal gastrectomy, Esophageal Neoplasms, medicine.medical_treatment, 030230 surgery, Anastomosis, 03 medical and health sciences, 0302 clinical medicine, Gastrectomy, Stomach Neoplasms, Carcinoma, medicine, Humans, Prospective Studies, Esophagogastric junction, Retrospective Studies, business.industry, Gastroenterology, medicine.disease, Surgery, Esophagectomy, Stenosis, 030220 oncology & carcinogenesis, Operative time, Laparoscopy, Esophagogastric Junction, business |
| الوصف: | We developed a novel technique for valvuloplastic esophagogastrostomy, named tri double-flap hybrid method (TDF). TDF is shown to be simple and useful for Siewert type II esophagogastric junction carcinoma. Research has found valvuloplastic esophagogastrostomy using the conventional hand-sutured double-flap (CDF) technique to be a useful anti-reflux procedure after proximal gastrectomy. However, no study has focused on this reconstruction procedure after laparoscopic transhiatal lower esophagectomy and proximal gastrectomy (LEPG) for esophagogastric junction carcinoma primarily because of its profound difficulty. Thus, we devised a novel technique for valvuloplastic esophagogastrostomy comprising triangular linear-stapled esophagogastrostomy and hand-sutured flap closure, which we term the tri double-flap hybrid (TDF) method. After reviewing our institution’s prospective gastric cancer database, 59 consecutive patients with Siewert type II esophagogastric junction carcinoma who underwent LEPG with valvuloplastic esophagogastrostomy from January 2014 to August 2018 were analyzed. Short- and mid-term surgical outcomes were then compared between the LEPG-TDF and LEPG-CDF groups to evaluate the efficacy of the TDF method. The median operative time was 316 min (184–613 min) and blood loss was 22.5 ml (0–180 ml). In comparison between the two groups, the LEPG-TDF group had a significantly shorter operative time (298 vs. 336 min, p = 0.041) and significantly lower postoperative anastomotic leak/stenosis rates (0 vs. 14.2%, p = 0.045), compared to the LEPG-CDF group. No patient suffered from severe gastroesophageal reflux symptoms (Visick score ≥ III). This study showed that double-flap valvuloplastic esophagogastrostomy is safe and feasible for reconstruction after LEPG for Siewert type II esophagogastric junction carcinoma. Moreover, the TDF method is a simple and useful technique that offers a shorter operative time and lower morbidity compared to the CDF technique. |
| تدمد: | 1873-4626 1091-255X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d625a86457d6e1a49dc67c30b0198ace https://doi.org/10.1007/s11605-020-04547-0 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....d625a86457d6e1a49dc67c30b0198ace |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 18734626 1091255X |
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