Laparoscopic gastrectomy for gastric stump cancer: analysis of 7 cases.
- Author:
Renchao ZHANG
;
Xiaowu XU
;
Yiping MOU
1
;
Yucheng ZHOU
;
Jiayu ZHOU
;
Chaojie HUANG
;
Yunyun XU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Anastomosis, Roux-en-Y; Blood Loss, Surgical; Female; Gastrectomy; Gastric Bypass; Gastric Stump; pathology; surgery; Humans; Laparoscopy; Length of Stay; Lymph Node Excision; Male; Middle Aged; Neoplasm Recurrence, Local; Operative Time; Retrospective Studies; Stomach Neoplasms; surgery; Surgical Stapling
- From: Chinese Journal of Gastrointestinal Surgery 2016;19(5):553-556
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the safety and feasibility of laparoscopic gastrectomy for gastric stump cancer.
METHODSClinical and follow-up data of 7 patients who underwent laparoscopic gastrectomy for gastric stump cancer in our department from January 2008 to July 2015 were analyzed retrospectively.
RESULTSThere were 5 male and 2 female patients, with a mean age of (62.1±10.7) years. Initial gastrectomy was performed for gastric cancer in 3 patients and peptic ulceration in 4. The initial surgery was B-II( gastrojejunostomy in 6 patients and Roux-en-Y gastrojejunostomy in 1. Duration between primary gastrectomy and occurrence of gastric stump cancer was ranged from 6-30 years for peptic ulceration, and from 11-15 years for gastric cancer. During the operation, adhesiolysis and exploration to locate the tumor were performed. Following total remnant gastrectomy and lymphadenectomy, intracorporeal anastomosis was accomplished by Roux-en-Y reconstruction. The methods of intracorporeal esophagojejunostomy were end-to-side approach using a circular stapler in 1 patient, side-to-side approach using an endoscopic linear staple in 2 patients, and hand-sewn technique in 4 patients. The operation time was (247.1±17.5) minutes and the intraoperative blood loss was (100.0±30.8) ml without transfusion. The number of retrieved lymph node was 19.1±4.8. The first flatus time, diet resumption time, postoperative hospital stay were (3.3±1.5) days, (3.7±0.8) days, (9.4±2.6) days, respectively. One patient experienced gastrointestinal bleeding that was managed conservatively and ultimately cured. Seven patients were followed up till January 2016. After follow-up from 6 to 38 months, 1 patient died of peritoneal metastasis 17 months after surgery, and 1 patient died of Alzheimer's disease 19 months after surgery. The other 5 patients were still alive without metastasis or recurrence.
CONCLUSIONLaparoscopic gastrectomy for gastric stump cancer is feasible and safe.