論文

査読有り
2013年4月

Laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis using a knifeless endoscopic linear stapler

Gastric Cancer
  • Hiroshi Okabe
  • ,
  • Kazutaka Obama
  • ,
  • Eiji Tanaka
  • ,
  • Shigeru Tsunoda
  • ,
  • Masatoshi Akagami
  • ,
  • Yoshiharu Sakai

16
2
開始ページ
268
終了ページ
274
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10120-012-0181-2

Proximal gastrectomy has been applied for selected patients with early upper gastric cancer, because of its potential advantages over total gastrectomy, such as preserving gastric capacity and entailing fewer hormonal and nutritional deficiencies. Esophago-gastric anastomosis is a simple reconstruction method with an excellent postoperative outcome provided that gastroesophageal reflux is properly prevented. Following open surgery, the esophagus is anastomosed to the anterior stomach wall with partial fundoplication to prevent esophageal reflux. We developed a novel laparoscopic hand-sewn method to reproduce the anti-reflux procedure that is used in open surgery. The esophagus is first fixed to the anterior stomach wall with a knifeless endoscopic linear stapler. This fixation contributes to maintaining a stable field for easier hand-sewn anastomosis, and allows us to complete the left side of the fundoplication at the same time. This novel technique was used to successfully perform complete laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis in ten patients, without any postoperative complications. No patient had symptoms of gastroesophageal reflux during a median follow-up period of 19.9 months. One patient developed anastomotic stenosis, and this was resolved with endoscopic dilatation. The mean percent body weight loss at 12 months after surgery, in comparison to the preoperative weight, was 10.4 %. Laparoscopic proximal gastrectomy with an esophago-gastric anastomosis using our novel technique would be a feasible choice would be a feasible choice and would show benefit for selected patients with early upper gastric cancer. © 2012 The International Gastric Cancer Association and The Japanese Gastric Cancer Association.

リンク情報
DOI
https://doi.org/10.1007/s10120-012-0181-2
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22825361
ID情報
  • DOI : 10.1007/s10120-012-0181-2
  • ISSN : 1436-3291
  • ISSN : 1436-3305
  • PubMed ID : 22825361
  • SCOPUS ID : 84880702483

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