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Laparoscopic proximal gastrectomy with oblique jejunogastrostomy

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/71398

Title: Laparoscopic proximal gastrectomy with oblique jejunogastrostomy
Authors: Tanaka, Kimitaka Browse this author →KAKEN DB
Ebihara, Yuma Browse this author →KAKEN DB
Kurashima, Yo Browse this author →KAKEN DB
Nakanishi, Yoshitsugu Browse this author →KAKEN DB
Asano, Toshimichi Browse this author →KAKEN DB
Noji, Takehiro Browse this author →KAKEN DB
Murakami, Soichi Browse this author →KAKEN DB
Nakamura, Toru Browse this author →KAKEN DB
Tsuchikawa, Takahiro Browse this author →KAKEN DB
Okamura, Keisuke Browse this author →KAKEN DB
Shichinohe, Toshiaki Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Proximal gastrectomy
Double-tract reconstruction
Gastric cancer
Laparoscopic surgery
Issue Date: Sep-2017
Publisher: Springer
Journal Title: Langenbeck's archives of surgery
Volume: 402
Issue: 6
Start Page: 995
End Page: 1002
Publisher DOI: 10.1007/s00423-017-1587-4
PMID: 28493146
Abstract: Background: Proximal early gastric cancer is a good indication for totally laparoscopic proximal gastrectomy (TLPG) with double-tract reconstruction (DTR). However, when most of the dietary intake passes through the escape route of the jejunum, the functional benefits of proximal gastrectomy might be similar to those after total gastrectomy. Our DTR procedure was improved for easy passage through the remnant stomach. The purposes of this study were to present a novel technique for intracorporeal DTR using linear staplers after TLPG and to investigate surgical outcomes. Methods: DTR was performed using linear staplers only. A side-to-side jejunogastrostomy with twisting of both the remnant stomach and the anal jejunum was performed for the purpose of passing meals through the remnant stomach (an oblique jejunogastrostomy technique). The ten patients who underwent TLPG with DTR from January 2011 to August 2016 in Hokkaido University Hospital were retrospectively reviewed. Their clinicopathological characteristics and surgical and postoperative outcomes were collected and analyzed. Results: The median duration of operation was 285 (range 146-440) min. No patients required blood transfusions. The number of dissected lymph nodes was 32 (range 22-56). There were no intraoperative complications, and no cases were converted to open surgery. All the patients were pT1N0M0 stage IA. No anastomotic leakage or complications were detected. Postoperative gastrography after reconstruction showed that contrast medium flowed mainly to the remnant stomach. The average percentage body weight loss was 14.0 +/- 7.1% at 10 months. The average percentage decrease in serum hemoglobin was 5.4 +/- 10.4% at 12 months. Conclusions: This novel technique for intracorporeal DTR provided a considerable advantage by the passage of dietary intake to the remnant stomach after LPG.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/71398
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 海老原 裕磨

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