Purpose: Esophagojejunostomy is a challenging step in laparoscopic gastrectomy. Although the overlap method is a safe and feasible approach for esophagojejunostomy, it has several technical limitations. We developed novel modifications for the overlap method to overcome these disadvantages.
Methods: Forty-eight consecutive gastric cancer patients underwent totally laparoscopic total gastrectomy or laparoscopic proximal gastrectomy with double-tract reconstruction at our institution from January 2019 to April 2020 using the overlap method with the following modifications. The esophagus was initially rotated by 90° counterclockwise, followed by transection of two-thirds of the esophageal diameter. The unstapled esophagus was then transected with a harmonic ultrasonic scalpel to enable esophagostomy at the posterior side of the esophagus. A side-to-side esophagojejunostomy was then formed at the posterior side of the esophagus using an endoscopic linear stapler through the right lower trocar. The common entry hole was closed via hand sewing method using V-Loc suture. This procedure was termed "esophagus two-step-cut overlap method."
Results: Only one patient suffered from esophagojejunal anastomotic leakage but subsequently recovered after conservative treatment. Patients did not experience anastomotic bleeding or stricture.
Conclusion: Our modified overlap method provides satisfactory surgical outcomes and overcomes several technical limitations, such as entering the false lumen of the esophagus, unnecessary pollution caused by nasogastric tube, and unintended left crus stapling during anastomosis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00423-021-02079-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes of Calcaneal Lengthening Osteotomy in Ambulatory Patients with Cerebral Palsy and Planovalgus Foot Deformity.
J Bone Joint Surg Am
January 2025
Division of Pediatric Orthopaedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Background: To date, no studies have evaluated the longevity of calcaneal lengthening osteotomy (CLO) in patients with cerebral palsy (CP) and pes planovalgus. This study aimed to explore the changes in foot alignment following CLO in patients with CP, utilizing both radiographic evaluations and dynamic foot-pressure assessments.
Methods: A retrospective study of 282 feet in 180 ambulatory patients was performed.
A comparative analysis of perceptual noise in lateral and depth motion: Evidence from eye tracking.
J Vis
January 2025
Vision and Control of Action (VISCA) Group, Department of Cognition, Development and Psychology of Education, Institut de Neurociències, Universitat de Barcelona, Barcelona, Catalonia, Spain.
The characterization of how precisely we perceive visual speed has traditionally relied on psychophysical judgments in discrimination tasks. Such tasks are often considered laborious and susceptible to biases, particularly without the involvement of highly trained participants. Additionally, thresholds for motion-in-depth perception are frequently reported as higher compared to lateral motion, a discrepancy that contrasts with everyday visuomotor tasks.
View Article and Find Full Text PDFKetogenic Diet-Associated Worsening of Osteoarthritis Histologic Secerity, Increased Pain Sensitivity and Gut Microbiome Dysbiosis in Mice.
ACR Open Rheumatol
January 2025
Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, the University of Oklahoma Health Sciences Center, and the Oklahoma City Veterans Affairs Medical Center.
Objectives: Dietary interventions are a potentially powerful treatment option for knee osteoarthritis (OA). The objective of this study was to evaluate a well-formulated ketogenic diet (KD) in the context of knee OA histology and pain using the destabilization of the medial meniscus (DMM) mouse model and correlate with gut microbiome and systemic cytokine levels.
Methods: Adult male mice underwent unilateral DMM or sham surgery and were then fed eight weeks of KD or chow.
Sex Differences in Lung Cancer Characteristics at Diagnosis: A Nationwide Register-Based Study From the Faroe Islands (2015-2020).
Cancer Rep (Hoboken)
January 2025
Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.
Background: Sex differences in lung cancer survival are well-established, but the gap between Faroese men and women is especially pronounced. Faroese women have some of the highest 1- and 5-year relative survival rates in the Nordic region, while Faroese men have some of the lowest. This study investigates these survival disparities by analyzing demographic, clinical, and temporal factors in Faroese lung cancer patients from 2015 to 2020.
View Article and Find Full Text PDFBreast MRI to Screen Women With Extremely Dense Breasts.
J Magn Reson Imaging
January 2025
Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Women with extremely dense breasts are at a higher risk of breast cancer, and the sensitivity of mammography in this group is reduced due to the masking effect of overlapping tissue. This review examines supplemental screening methods to improve detection in this population, with a focus on MRI. Morphologic techniques offer limited benefits, digital breast tomosynthesis (DBT) shows inconsistent results, and ultrasound (US), while improving cancer detection rates (CDR), results in a higher rate of false positives.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!