New technique of esophagogastrostomy and esophagojejunostomy after laparoscopic gastrectomy
10.3760/cma.j.issn.1673-9752.2011.03.011
- VernacularTitle:腹腔镜胃切除后食管残胃和食管空肠吻合新技术
- Author:
Chongwei KE
;
Danlei CHEN
;
Dan DING
- Publication Type:Journal Article
- Keywords:
Gastric neoplasms;
Laparoseopy;
Gastrectomy;
Esophagogastrostomy;
Esophagojejunostomy
- From:
Chinese Journal of Digestive Surgery
2011;10(3):191-195
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of transorally inserted anvil system(OrVilTM)in esophagogastrostomy and esophagojejunostomy after laparoscopic gastrectomy.Methods The clinical data of 34 patients with gastric neoplasms who were installed OrVilTM for esophagogastrostomy or esophagojejunostomy at the Changhai Hospital from July 2009 to February 2011 were retrospectively analyzed.After radical dissection of lymph nodes and full mobilization of esophagus,the esophagus was transected and the anvil was then transorally inserted into the esophagus by using the OrVilTB system.Double-stapling esophagogastrustomy or esophagojejunostomy with a circular stapler Was performed intracorporeally under direct laparuscopic view.Results The surgery was success fully completed in all the 34 patients with no conversion to open surgery.Two patients had difficulty in placing OrVilTM system.and the condition Was alleviated by reducing tension in the cuff and tilting the head back.The mean operation time,volume of blood loss,duration of postoperative hospital stay and time to gastrointestinal function recovery were 175 minutes(range,90-240 minutes),196 ml(range,50-800 ml),7.6 days(range,5-14 days)and 3 days(range,2-6 days).No postoperative anastomotic leakage Was detected.Thirty-three patients were followed up for 2-20 months with a mean time of(10±6)months,and no tumor recurrence or metastasis occurred.Conclusion OrVilTM system changes insert direction of the anvil,which significantly reduces the difficulty of laparoscopic operation,shortens the operation time and avoids the thoracotomy.
