MISC

国際誌
2019年12月9日

Linear or circular stapler? A propensity score-matched, multicenter analysis of intracorporeal esophagojejunostomy following totally laparoscopic total gastrectomy.

Surgical endoscopy
  • Katsuhiro Murakami
  • Kazutaka Obama
  • Shigeru Tsunoda
  • Shigeo Hisamori
  • Tatsuto Nishigori
  • Koya Hida
  • Seiichiro Kanaya
  • Seiji Satoh
  • Dai Manaka
  • Michihiro Yamamoto
  • Yoshio Kadokawa
  • Atsushi Itami
  • Hiroshi Okabe
  • Hiroaki Hata
  • Eiji Tanaka
  • Yoshito Yamashita
  • Masato Kondo
  • Hisahiro Hosogi
  • Nobuaki Hoshino
  • Shiro Tanaka
  • Yoshiharu Sakai
  • 全て表示

34
12
開始ページ
5265
終了ページ
5273
記述言語
英語
掲載種別
Scientific Journal
DOI
10.1007/s00464-019-07313-9

BACKGROUND: Presently, there is no consensus as to what procedure of intracorporeal esophagojejunostomy (EJS) in totally laparoscopic total gastrectomy (TLTG) is best to reduce postoperative complications. The aim of this study was to demonstrate the superiority of linear stapled reconstruction in terms of anastomotic-related complications for EJS in TLTG. METHODS: We collected data on 829 consecutive gastric cancer patients who underwent TLTG reconstructed by the Roux-en-Y method with radical lymphadenectomy between January 2010 and December 2016 in 13 hospitals. The patients were divided into two groups according to reconstruction method and matched by propensity score. Postoperative EJS-related complications were compared between the linear stapler (LS) and the circular stapler (CS) groups. RESULTS: After matching, data from 196 patients in each group were analyzed. The overall incidence of EJS-related complications was significantly lower in the LS group than in the CS group (4.1% vs. 11.7%, p = 0.008). The incidence of EJS anastomotic stenosis during the first year after surgery was significantly lower in the LS group than in the CS group (1.5% vs. 7.1%, p = 0.011). The incidence of EJS bleeding did not differ significantly between the groups, although no bleeding was observed in the LS group (0% vs. 2.0%, p = 0.123). The incidence of EJS leakage did not differ significantly between the groups (2.6% vs. 3.6%, p = 0.771). CONCLUSION: The use of linear stapled reconstruction is safer than the use of circular stapled reconstruction for intracorporeal EJS in TLTG because of its lower risks of stenosis.

リンク情報
DOI
https://doi.org/10.1007/s00464-019-07313-9
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31820152
ID情報
  • DOI : 10.1007/s00464-019-07313-9
  • PubMed ID : 31820152

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