論文

査読有り
2016年9月

Technique of Roux-en-Y reconstruction using overlap method after laparoscopic total gastrectomy for gastric cancer: 100 consecutively successful cases

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
  • Hidehiko Kitagami
  • ,
  • Mamoru Morimoto
  • ,
  • Kenichi Nakamura
  • ,
  • Takahiro Watanabe
  • ,
  • Yo Kurashima
  • ,
  • Keisuke Nonoyama
  • ,
  • Kaori Watanabe
  • ,
  • Shiro Fujihata
  • ,
  • Akira Yasuda
  • ,
  • Minoru Yamamoto
  • ,
  • Yasunobu Shimizu
  • ,
  • Moritsugu Tanaka

30
9
開始ページ
4086
終了ページ
4091
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00464-015-4724-6
出版者・発行元
SPRINGER

We have established a standard procedure for Roux-en-Y (RY) reconstruction in laparoscopic total gastrectomy (LTG) using esophagojejunostomy by the overlap method (OL). We report on our RY reconstruction technique and special approaches, and evaluate the usefulness of our reconstruction method based on the surgical results of 100 patients we have experienced to date.
We performed LTG in 100 patients with gastric cancer. After total gastrectomy using five ports, the resected stomach was extracted through a small laparotomy. Through that, we performed sacrifice of the jejunum, Y limb anastomosis, creation of the lifted jejunum. As the OL, a side-to-side anastomosis of the lifted jejunum to the esophageal stump was laparoscopically performed using a linear stapler in an isoperistaltic direction, and the entry hole was closed with full-thickness suturing. The lifted jejunum was fixed with suture to the duodenal stump at a location where the esophagojejunostomy site was made linear, and the duodenal stump was buried. The mesenteric gap was laparoscopically closed with suture.
The median operative time in 100 patients undergoing LTG was 385 min, the median blood loss was 65 mL, and the median time required for the OL was 32 min. The mean hospitalization period was 10 days, and postoperative complications included bleeding requiring reoperation in one patient; other complications such as pancreatic fistula in five patients (5 %) were treated conservatively. No complication associated with anastomosis occurred.
In RY reconstruction using the OL, there were no complications associated with the anastomosis site in 100 consecutive patients, such as anastomotic leak or stenosis, indicating that it is a very useful and safe reconstruction method.

Web of Science ® 被引用回数 : 26

リンク情報
DOI
https://doi.org/10.1007/s00464-015-4724-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26701704
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000382117700055&DestApp=WOS_CPL
ID情報
  • DOI : 10.1007/s00464-015-4724-6
  • ISSN : 0930-2794
  • eISSN : 1432-2218
  • PubMed ID : 26701704
  • Web of Science ID : WOS:000382117700055

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