Laparoscopic total gastrectomy is on the rise. One of the most technically demanding steps of the approach is the construction of esophago-jejunal anastomosis. Several laparoscopic anastomotic techniques have been described, like linear stapler side-to-side or circular stapler end-to-side anastomosis; limited data exist regarding hand-sewn esophago-jejunal anastomosis. The study took place between January 2018 and June 2021. Patients enrolled in this study were adults with proximal gastric or esophago-gastric junction Siewert type III tumors that underwent 3D-assisted laparoscopic total gastrectomy. A hand-sewn esophago-jejunal anastomosis was performed in all cases laparoscopically. Forty consecutive cases were performed during the study period. Median anastomotic suturing time was 55 min, with intra-operative methylene blue leak test being negative in all cases. Median operating time was 240 min, and there were no conversions to open. The anastomotic leak rate and postoperative stricture rate were zero. The 30- and 90-day mortality rates were zero. Laparoscopic manual esophago-jejunal anastomosis utilizing a 3D platform in total gastrectomy for cancer can be performed with excellent outcomes regarding anastomotic leak and stricture rate. This anastomotic approach, although technically challenging, is safe and reproducible, with prominent results that can be disseminated in the surgical community.
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http://dx.doi.org/10.3390/cancers13184709 | DOI Listing |
Arq Bras Cir Dig
December 2024
Pontificia Universidad Católica de Chile, Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department - Santiago, Metropolitan Region, Chile.
Background: Laparoscopic gastrectomy offers advantages in the postoperative period compared to the open approach. Most studies have been performed on distal gastrectomies; however, laparoscopic total gastrectomy (LTG) is not universally accepted. AIM: The aim of this study was to assess the results of LTG, on postoperative morbidity outcomes and long-term survival.
View Article and Find Full Text PDFLangenbecks Arch Surg
November 2024
Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami- Ku, Sagamihara, Kanagawa, 252-0375, Japan.
Background: The appropriate extent of resection for esophagogastric junction cancer and the method of surgical approach remain controversial. This study aimed to assess the safety and outcomes of the parachute technique, which is an open transhiatal reconstruction method that facilitates stable reconstruction.
Materials And Methods: The surgical outcomes of 20 consecutive patients who underwent open lower- esophagogastrectomy for EGJ cancer at Kitasato University Hospital from June 2019 to July 2023 were retrospectively reviewed.
Cureus
June 2024
Thoracic Surgery, University Hospital "St. Ivan Rilski", Medical University of Sofia, Sofia, BGR.
An inflammatory fibroid polyp (Vaněk's polyp) is a rare, benign, mesenchymal polyp originating from the submucosa of the gastrointestinal tract. Symptoms are non-specific and depend on the tumor size and location. Despite their benign nature, these tumors can mimic other malignant conditions, making an accurate diagnosis crucial for appropriate management.
View Article and Find Full Text PDFAnn Med Surg (Lond)
May 2024
Department of Surgery, Patan Academy of Health Sciences, Lalitpur.
Introduction And Importance: Gastric leiomyosarcoma is a rare malignant tumor among the primary gastric carcinomas. Among the different common presentations, dysphagia is an uncommon presentation of gastric leiomyosarcoma.
Case Presentation: A 29-year-old female presented with complaints of progressive dysphagia for 1 year associated with vomiting, significant weight loss, and anorexia for 6 months.
Pol Przegl Chir
April 2024
Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medicine in Katowice, Silesian Medical University in Katowice, Poland.
<b><br>Indroduction:</b> Significant dysphagia, aspiration pneumonia, and impossible oral nutrition in patients with unresectable or recurrent gastroesophageal malignancy or bronchial cancer invading the oesophagus with a tracheoesophageal fistula lead to cachexia. Dehiscence of the esophago-jejunal or gastroesophageal anastomosis may cause severe oesophageal haemorrhage. We believe that X-ray-guided oesophageal stent implantation (SEMS) is an alternative palliative method for microjejunostomy or full parenteral nutrition.
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