| Título : |
A Step-Wise Approach to Total Laparoscopic Gastrectomy with Jejunal Pouch Reconstruction: How and Why We Do It |
| Tipo de documento : |
documento electrónico |
| Autores : |
Juan Camilo Correa Cote, |
| Fecha de publicación : |
2016 |
| Títulos uniformes : |
Journal of Gastrointestinal Surgery
|
| Idioma : |
Inglés (eng) |
| Palabras clave : |
Laparoscopy gastrectomy jejunal pouch gastric cancer |
| Resumen : |
Laparoscopic gastrectomy (LG) is a safe alternative compared to open gastrectomy for cancer. To increase the uptake of minimally invasive approaches and facilitate their analysis and improvement a stepwise approach is warranted. This study describes our technique and experiences total laparoscopic gastrectomy (TLG) with jejunal pouch reconstruction for gastric cancer. Technical modifications throughout the years were described. In patients with anastomotic leakage, the CT-scan and reoperation report were reviewed to identify the location and cause of the leak. A total of 47 patients who underwent laparoscopic total gastrectomy with extracorporeal jejunal pouch reconstruction and stapled circular esophagojejunostomy from May 2007 to August 2015 were prospectively analyzed. A stepwise approach of 10 steps was designed based on video and case analysis. Median operation time was 301 (148–454) minutes and median blood loss was 300 (30–900) milliliters. Anastomotic leakage occurred in six (12.8 %) patients; additionally, one (2.12 %) jejunal-pouch staple line leak was identified. An important modification in our technique was a purse-string suture around the anvil of the circular stapler to prevent esophageal mucosa to slip away. After this modification, the leakage rate was reduced to 7 % in the last 15 procedures. In conclusion, TLG with jejunal pouch reconstruction is a feasible procedure in a selected group of patients. Our stepwise approach and technique may help surgeons to introduce jejunal pouch reconstruction during laparoscopic gastrectomy in their center. |
| Mención de responsabilidad : |
Hylke J F Brenkman, Juan Correa-Cote, Jelle P Ruurda, Richard van Hillegersberg |
| Referencia : |
J Gastrointest Surg. 2016 Nov;20(11):1908-1915. |
| DOI (Digital Object Identifier) : |
10.1007/s11605-016-3235-7 |
| PMID : |
27561635 |
| En línea : |
https://link.springer.com/article/10.1007%2Fs11605-016-3235-7 |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3972 |
A Step-Wise Approach to Total Laparoscopic Gastrectomy with Jejunal Pouch Reconstruction: How and Why We Do It [documento electrónico] / Juan Camilo Correa Cote, . - 2016. Obra : Journal of Gastrointestinal SurgeryIdioma : Inglés ( eng) | Palabras clave : |
Laparoscopy gastrectomy jejunal pouch gastric cancer |
| Resumen : |
Laparoscopic gastrectomy (LG) is a safe alternative compared to open gastrectomy for cancer. To increase the uptake of minimally invasive approaches and facilitate their analysis and improvement a stepwise approach is warranted. This study describes our technique and experiences total laparoscopic gastrectomy (TLG) with jejunal pouch reconstruction for gastric cancer. Technical modifications throughout the years were described. In patients with anastomotic leakage, the CT-scan and reoperation report were reviewed to identify the location and cause of the leak. A total of 47 patients who underwent laparoscopic total gastrectomy with extracorporeal jejunal pouch reconstruction and stapled circular esophagojejunostomy from May 2007 to August 2015 were prospectively analyzed. A stepwise approach of 10 steps was designed based on video and case analysis. Median operation time was 301 (148–454) minutes and median blood loss was 300 (30–900) milliliters. Anastomotic leakage occurred in six (12.8 %) patients; additionally, one (2.12 %) jejunal-pouch staple line leak was identified. An important modification in our technique was a purse-string suture around the anvil of the circular stapler to prevent esophageal mucosa to slip away. After this modification, the leakage rate was reduced to 7 % in the last 15 procedures. In conclusion, TLG with jejunal pouch reconstruction is a feasible procedure in a selected group of patients. Our stepwise approach and technique may help surgeons to introduce jejunal pouch reconstruction during laparoscopic gastrectomy in their center. |
| Mención de responsabilidad : |
Hylke J F Brenkman, Juan Correa-Cote, Jelle P Ruurda, Richard van Hillegersberg |
| Referencia : |
J Gastrointest Surg. 2016 Nov;20(11):1908-1915. |
| DOI (Digital Object Identifier) : |
10.1007/s11605-016-3235-7 |
| PMID : |
27561635 |
| En línea : |
https://link.springer.com/article/10.1007%2Fs11605-016-3235-7 |
| Enlace permanente : |
https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3972 |
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