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Minerva Surgery 2021 Jun 23

DOI: 10.23736/S2724-5691.21.08798-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Laparoscopic mechanical latero-lateral oesophagojejunostomy after total gastrectomy for cancer in the elderly: technical notes and results

Luca P. EVOLI 1, Lavinia AMATO 1 , Claudio RENZI 1, Manuel VALERI 1, Orazio CAPONE 2, Nadia GIULIANI 3, Maurizio CESARI 3, Alessandro CONTINE 3

1 University of Perugia, Perugia, Italy; 2 University of Rome Tor Vergata, Policlinico Universitario di Roma PTV, Rome, Italy; 3 Città di Castello Hospital, Department of General Surgery, Città di Castello, Italy


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BACKGROUND: The realization of a oesophagojejunostomy is a critical step in total gastrectomy. Several techniques based on a Roux-En-Y restoration of gastrointestinal continuity were described with similar results. We here report our laparoscopic experience in intracorporeal oesophagojejunostomy.
METHODS: Adults who underwent laparoscopic total gastrectomy for cancer with laterolateral (functional termino-terminal) Roux en Y intracorporeal oesophagojejunostomy with linear stapler from January 2014 to December 2018 were included. Demographics, intra and postoperative outcomes including 30-day readmissions and mortality were considered.
RESULTS: 32 patients were included. Nodal dissection D1’s were 16. Median operative time was 280’. median blood loss was 200 mL. Fluid oral intake is usually resumed on the second postoperative day and soft solid diet is started on the third postoperative day. Three patients had minimal anastomotic leakage and they underwent Non Operative Management. Median postoperative stay was 8.5 days.
CONCLUSIONS: This technique may improve the ergonomics of oesophagojejunostomy creation. The procedure is suitable for experienced laparoscopic surgeons.


KEY WORDS: Laparoscopy; Gastrectomy; Stomach neoplasms; Surgical, anastomosis; Aged

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