PURPOSE: Different esophagojejunostomy (EJ) reconstruction methods are used after totally laparoscopic total gastrectomy (TLTG), and none is considered a standard technique. This report describes a 2-layer hand-sewn EJ technique during TLTG; we also evaluated postoperative morbidity associated with this technique. MATERIALS AND METHODS: This retrospective cohort study included all consecutive patients who underwent TLTG for gastric cancer (GC) from 2012 to 2016 at 2 affiliated teaching hospitals. All participating surgeons performed standardized intracorporeal 2-layer hand-sewn EJ. RESULTS: We included 51 patients who underwent TLTG for GC and standardized EJ anastomosis. Twenty-seven (53%) were male, and the median age was 60 (36–87) years. The average operative time was 337±71 minutes and intraoperative bleeding was 160±107 mL. There were no open conversions related to EJ. Postoperative morbidity was observed in 9 (17.0%) patients. There was no postoperative mortality. EJ leakage was observed in 2 patients (3.8%) and 1 patient (1.9%) developed EJ stenosis. Patients with leakage were managed non-operatively and the patient with stenosis required endoscopic dilation. The median length of hospital stay was 8 (6–29) days. CONCLUSIONS: Two-layer hand-sewn EJ during TLTG for GC is a feasible and safe technique. This method avoids a laparotomy for reconstruction and the disadvantages associated with laparoscopic introduction of mechanical staplers for EJ, and provides an alternative for alimentary tract reconstruction after TLTG.
Cohort Studies ; Constriction, Pathologic ; Gastrectomy* ; Hemorrhage ; Hospitals, Teaching ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Male ; Methods ; Mortality ; Operative Time ; Retrospective Studies ; Stomach Neoplasms* ; Surgeons

Objectives: The coronavirus disease 2019 pandemic led to various intensities of lockdowns, affecting lifestyles globally. This study investigates the impact of partial lockdown versus total lockdown on adult physical activity (PA) and sedentary behavior. Methods: A cross-sectional online survey was conducted from April 2020 to October 2020, with 493 participants included in the analysis. Results: The analysis revealed no significant differences in total PA or total sitting time between partial lockdown and total lockdown scenarios. However, moderate physical activity (MPA) significantly decreased during total lockdowns, with more pronounced reductions among females than males. Notably, a positive correlation was found between household area and MPA, suggesting that larger living spaces may encourage more PA. A negative correlation was observed between sitting time and MPA during both types of lockdown. Conclusions Total lockdown conditions were associated with a significant decrease in MPA, highlighting sex disparities in PA responses. Living space size emerged as a crucial factor in maintaining PA levels during restricted conditions. This study emphasizes the need to consider environmental and demographic factors in public health strategies during prolonged periods of restricted movement.

Objectives: The coronavirus disease 2019 pandemic led to various intensities of lockdowns, affecting lifestyles globally. This study investigates the impact of partial lockdown versus total lockdown on adult physical activity (PA) and sedentary behavior. Methods: A cross-sectional online survey was conducted from April 2020 to October 2020, with 493 participants included in the analysis. Results: The analysis revealed no significant differences in total PA or total sitting time between partial lockdown and total lockdown scenarios. However, moderate physical activity (MPA) significantly decreased during total lockdowns, with more pronounced reductions among females than males. Notably, a positive correlation was found between household area and MPA, suggesting that larger living spaces may encourage more PA. A negative correlation was observed between sitting time and MPA during both types of lockdown. Conclusions Total lockdown conditions were associated with a significant decrease in MPA, highlighting sex disparities in PA responses. Living space size emerged as a crucial factor in maintaining PA levels during restricted conditions. This study emphasizes the need to consider environmental and demographic factors in public health strategies during prolonged periods of restricted movement.

Objectives: The coronavirus disease 2019 pandemic led to various intensities of lockdowns, affecting lifestyles globally. This study investigates the impact of partial lockdown versus total lockdown on adult physical activity (PA) and sedentary behavior. Methods: A cross-sectional online survey was conducted from April 2020 to October 2020, with 493 participants included in the analysis. Results: The analysis revealed no significant differences in total PA or total sitting time between partial lockdown and total lockdown scenarios. However, moderate physical activity (MPA) significantly decreased during total lockdowns, with more pronounced reductions among females than males. Notably, a positive correlation was found between household area and MPA, suggesting that larger living spaces may encourage more PA. A negative correlation was observed between sitting time and MPA during both types of lockdown. Conclusions Total lockdown conditions were associated with a significant decrease in MPA, highlighting sex disparities in PA responses. Living space size emerged as a crucial factor in maintaining PA levels during restricted conditions. This study emphasizes the need to consider environmental and demographic factors in public health strategies during prolonged periods of restricted movement.