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RISS 인기검색어
- 검색키워드
- 저자 : Masahito Uji (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Yuichi Takayama,Yuji Kaneoka,Atsuyuki Maeda,Yasuyuki Fukami,Takamasa Takahashi,Masahito Uji 대한위암학회 2019 Journal of gastric cancer Vol.19 No.3
Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclearbecause a purse-string suture for fixing the anvil into the esophagus is difficult to performwith a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique tofix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treatedat our institution with an intracorporeal circular esophagojejunostomy in a laparoscopyassistedtotal gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopyassistedproximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 ofthe esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next,the anvil head of a circular stapler was introduced into the esophagus. Finally, the circularesophagojejunostomy was performed laparoscopically. The clinical characteristics andsurgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn pursestringsuturing time was 6.4 minutes. The overall incidence of postoperative complications(Clavien–Dindo classification grade ≥II) was 26%. The number of patients with ananastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12(6.0%), respectively. All patients with stenosis were successfully treated by endoscopicballoon dilatation. There was no mortality. Regarding the materials and devices for anvilfixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligationmethod is simple and safe.
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Takayama, Yuichi,Kaneoka, Yuji,Maeda, Atsuyuki,Fukami, Yasuyuki,Takahashi, Takamasa,Uji, Masahito The Korean Gastric Cancer Association 2019 Journal of gastric cancer Vol.19 No.3
Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ${\geq}II$) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.
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