ORIGINAL ARTICLE   

Minerva Surgery 2022 February;77(1):35-40

DOI: 10.23736/S2724-5691.21.08798-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Laparoscopic mechanical latero-lateral esophagojejunostomy 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 Tor Vergata Polyclinic, Tor Vergata University, Rome, Italy; ³ Department of General Surgery, Città di Castello Hospital, Città di Castello, Perugia, Italy

BACKGROUND: The realization of an esophagojejunostomy 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 report our laparoscopic experience in intracorporeal esophagojejunostomy.
METHODS: Adults who underwent laparoscopic total gastrectomy for cancer with latero-lateral (functional termino-terminal) Roux en Y intracorporeal esophagojejunostomy 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: Thirty-two patients were included. Nodal dissection D1 was 16. Median operative time was 280ʹ. 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 nonoperative management. Median postoperative stay was 8.5 days.
CONCLUSIONS: This technique may improve the ergonomics of esophagojejunostomy creation. The procedure is suitable for experienced laparoscopic surgeons.

KEY WORDS: Laparoscopy; Gastrectomy; Stomach neoplasms; Anastomosis, surgical; Aged