Catheter-guided anvil insertion for circular stapler esophagojejunal anastomosis: a novel technique in laparoscopic total gastrectomy,Updates in Surgery

当前位置： X-MOL 学术 › Updates Surg. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Catheter-guided anvil insertion for circular stapler esophagojejunal anastomosis: a novel technique in laparoscopic total gastrectomy
Updates in Surgery ( IF 2.4 ) Pub Date : 2024-03-07 , DOI: 10.1007/s13304-024-01753-2
Zeyao Ye ₁ , Pengfei Yu ₁ , Yang Cao ₁ , Yian Du ₁

Affiliation

Objective

This study evaluates feasibility, safety, and short-term outcomes of employing the catheter-guided stapler anvil insertion technique for esophagojejunal anastomosis using a circular stapler during laparoscopic total gastrectomy (LTG).

Materials and methods

From September 2021 to April 2023, the catheter-guided stapler anvil insertion technique was employed in 80 patients undergoing laparoscopic total gastrectomy (LTG) for esophagojejunal anastomosis. A modified D2 dissection, according to the en bloc technique, was performed in the patients. Subsequently, a longitudinal incision, approximately 2 cm in length, was made on the anterior wall of the esophagus, about 2 cm above the tumor. The transection line was pre-marked with blue dye along the esophagus's minor axis, and the tail of the anvil was capped with a 10-cm length of catheter (F14 d4.7 mm). The surgeon secures the head of anvil and carefully inserts it into the esophagus, ensuring that only a 5-cm segment of the catheter remains outside the esophagus. A linear cutter was employed to transect and seal the lower end of the esophagus. Subsequently, esophagojejunostomy was performed under laparoscopic guidance using a circular stapler.

Results

Among patients undergoing esophagojejunal anastomosis with the new technique, postoperative complications included pneumonia or pleural effusion in 14 patients (17.5%), anastomotic stenosis in 3 patients (3.75%), abdominal infection in 2 patients (2.5%), and intestinal obstruction in 1 patient (1.25%). No instances of anastomotic leakage, anastomotic bleeding, or deaths were recorded. All patients experiencing complications improved with conservative treatment, without the need for secondary surgery.

Conclusion

The catheter-guided stapler anvil insertion technique is demonstrated to be a safe and effective method for esophagojejunostomy, potentially reducing the occurrence of anastomotic leakage.

中文翻译：

导管引导砧座插入圆形吻合器食管空肠吻合术：腹腔镜全胃切除术的新技术

客观的

本研究评估了腹腔镜全胃切除术 (LTG) 期间使用圆形吻合器进行食管空肠吻合的导管引导吻合器砧座插入技术的可行性、安全性和短期结果。

材料和方法

2021年9月至2023年4月，我们对80例腹腔镜全胃切除术（LTG）食管空肠吻合术患者采用了导管引导吻合器砧座插入技术。根据整体技术，对患者进行了改良的 D2 解剖。随后，在肿瘤上方约2cm处的食管前壁上切一个长约2cm的纵向切口。沿食管短轴用蓝色染料预先标记横断线，并用 10 厘米长的导管（F14 d4.7 毫米）盖住砧座的尾部。外科医生固定砧座头部并小心地将其插入食道，确保只有 5 厘米的导管段留在食道外。使用线性切割器横切并密封食道的下端。随后，使用圆形吻合器在腹腔镜引导下进行食管空肠吻合术。