Safety and feasibility of intrathoracic modified overlap esophagojejunostomy in laparoscopic radical resection of Siewert type Ⅱ adenocarcinoma of esophagogastric junction.
10.3760/cma.j.cn441530-20210222-00075
- VernacularTitle:胸腔内改良Overlap法在腹腔镜SiewertⅡ型食管胃结合部腺癌手术中的应用价值
- Author:
Yan CHEN
1
;
Wen Jun XIONG
2
;
Yan Sheng ZHENG
2
;
Li Jie LUO
2
;
Jin LI
2
;
Xiao Feng ZHU
2
;
Si Jing LUO
3
;
Yu Ting XU
4
;
Jin WAN
2
;
Wei WANG
2
Author Information
1. Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China Department of Traditional Chinese Medicine Surgery, The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
2. Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China.
3. Department of First Surgical, Zhuhai Hospital, Guangdong Provincial Hospital of Chinese Medicine, Zhuhai 519015, China.
4. Department of Anorectal, Zhongshan Hospital, Guangdong Provincial Hospital of Chinese Medicine, Zhongshan 528401, China.
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of the esophagogastric junction, Siewert type II;
Laparoscope;
Modified overlap method in thoracic cavity
- MeSH:
Adenocarcinoma/surgery*;
Anastomosis, Surgical;
Esophagogastric Junction/surgery*;
Feasibility Studies;
Gastrectomy/methods*;
Humans;
Laparoscopy/methods*;
Retrospective Studies;
Stomach Neoplasms/pathology*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(2):173-178
- CountryChina
- Language:Chinese
-
Abstract:
Objective: The study aimed to investigate the safety and feasibility of intrathoracic modified overlap method in laparoscopic radical resection of Siewert type II adenocarcinoma of the esophagogastric junction (AEG). Methods: A descriptive case series study was conducted. The clinical data of 27 patients with Siewert type II AEG who underwent transthoracic single-port assisted laparoscopic total gastrectomy and intrathoracic modified overlap esophagojejunostomy in Guangdong Provincial Hospital of Chinese Medicine from May 2017 to December 2020 were retrospectively analyzed. The intrathoracic modified overlap esophagojejunostomy was performed as follows: (1) The Roux-en-Y loop was made; (2) The jejunum side was prepared extraperitoneal for overlap anastomosis; (3) The esophagus side was prepared intraperitoneal for overlap anastomosis; (4) The overlap esophagojejunostomy was performed; (5) The common outlet was closed after confirmation of anastomosis integrity without bleeding; (6) A thoracic drainage tube was inserted into the thoracic hole with the diaphragm incision closed. The intraoperative and postoperative results were reviewed. Results: All 27 patients were successfully operated, without mortality or conversion to laparotomy. The operative time, digestive tract reconstruction time and esophageal-jejunal anastomosis time were (327.5±102.0) minute, 50 (28-62) minute and (29.0±7.4) minute, respectively. The blood loss was 100 (20-150) ml. The postoperative time to flatus and postoperative hospital stay were (4.7±3.7) days and 9(6-73) days, respectively. Three patients (11.1%) developed postoperative grade III complications according to the Clavien-Dindo classification, including 1 case of anastomotic fistula with empyema, 1 case of pleural effusion and 1 case of pancreatic fistula, all of whom were cured by puncture drainage and anti-infective therapy. Conclusions: The intrathoracic modified overlap esophagojejunostomy is safe and feasible in laparoscopic radical resection of Siewert type II AEG.
