Application of jejunum-later-cut Overlap method for esophagojejunostomy during totally laparoscopic total gastrectomy
Objective To explore the advantages and safety of jejunum-later-cut Overlap method versus traditional Overlap method during totally laparoscopic total gastrectomy(TLTG).Methods From March 2018 to June 2023,the relevant clinical data were retrospectively reviewed for 43 patients underwent TLTG at First Municipal People's Hospital.According to different esophagojejunal anastomosis modes,they were assigned into two groups of jejunum-later-cut Overlap(n=25)and traditional overlap(n=18).The perioperative and postoperative short-term parameters were compared between two groups.Results No statistically significant inter-group differences existed in general profiles(all P>0.05).All operations were completed successfully without any conversion into open surgery.During follow-ups,jejunum-later-cut overlap group resumed a semi-liquid or normal diet at Month 1 post-operation and started a normal diet at Month 3 post-operation.No significant differences existed in intraoperative volume of blood loss,postoperative hospitalization stay or the incidence of such anastomotic complications as eakage,stenosis or hemorrhage(all P>0.05).As compared with traditional Overlap group,durations of esophagojejunostomy[(25.4±4.3)vs(39.8±4.5)min,t=-10.549,P<0.001]and operative duration[237(230-250)vs 258.6(250-285)min,Z=-5.517,P<0.001]were significantly shorter in jejunum-later-cut overlap group than those in traditional overlap group and the differences were statistically significant(all P<0.001).Conclusion In patients undergoing TLTG,jejunum-later-cut Overlap method is more convenient than traditional Overlap method and anastomosis is better,safe and feasible.
Totally laparoscopic total gastrectomyGastric cancerOverlap
万方数据
维普
