Journal
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES
Volume 27, Issue 3, Pages 197-202Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SLE.0000000000000409
Keywords
gastric cancer; laparoscopic; total gastrectomy; esophagojejunostomy; functional end-to-end anastomosis
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Funding
- Grants-in-Aid for Scientific Research [16K10525, 15K10125, 15K10126] Funding Source: KAKEN
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Background:We performed esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG) using functional end-to-end anastomosis (FEEA) as the first choice and laparoscopic-assisted total gastrectomy (LATG) using a circular stapler with a transorally inserted anvil as the second choice.Patients and Methods:We examined 109 patients with gastric cancer who underwent TLTG and LATG. Among these, 100 patients underwent TLTG and the rest underwent LATG.Results:The length of resected esophageal segment in LATG patients was significantly longer than that in TLTG patients (P<0.001). The length of the resected esophagus segment was inversely correlated with body mass index in cases of esophagojejunostomy by FEEA (P<0.05). Multivariate analysis revealed that T factor, N factor, and severe complications were the independent factors for survival.Conclusions:Esophagojejunostomy using FEEA or a circular stapler with a transorally inserted anvil should be selected according to the length of the resected esophageal segment and/or body mass index.
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