Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction

ZHANG Chensong; PAN Chengwu; WANG Qingkang; WANG Yuanpeng; WU Han; MA Jiachi

doi:10.16766/j.cnki.issn.1674-4152.003543

Volume 22 Issue 6

Jun. 2024

Turn off MathJax

Article Contents

Article Navigation > Chinese Journal of General Practice > 2024 > 22(6): 957-961

ZHANG Chensong, PAN Chengwu, WANG Qingkang, WANG Yuanpeng, WU Han, MA Jiachi. Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction[J]. Chinese Journal of General Practice, 2024, 22(6): 957-961. doi: 10.16766/j.cnki.issn.1674-4152.003543

Citation:

ZHANG Chensong, PAN Chengwu, WANG Qingkang, WANG Yuanpeng, WU Han, MA Jiachi. Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction[J]. Chinese Journal of General Practice, 2024, 22(6): 957-961. doi: 10.16766/j.cnki.issn.1674-4152.003543

Citation:

ZHANG Chensong, PAN Chengwu, WANG Qingkang, WANG Yuanpeng, WU Han, MA Jiachi. Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction[J]. Chinese Journal of General Practice, 2024, 22(6): 957-961. doi: 10.16766/j.cnki.issn.1674-4152.003543

PDF( 1403 KB)

Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction

doi: 10.16766/j.cnki.issn.1674-4152.003543

1.
Department of Oncology Surgery, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

Funds:

2208085MH242

2023AH051990

20220130

2023032

Received Date: 2023-12-04
Available Online: 2024-07-22

Abstract

Abstract

Objective To analyze the short-term clinical efficacy and safety of total laparoscopic π-shaped esophageal jejunostomy and laparoscopic assisted Roux-en-Y esophago-jejunostomy for adenocarcinoma of the esophagogastric junction. Methods The clinical and pathological data of 72 patients with adenocarcinoma of the esophagogastric junction treated in the First Affiliated Hospital of Bengbu Medical University from June 2020 to July 2022 were collected. All patients underwent laparoscopic total gastrectomy + D2 lymphadenectomy, in whom 38 patients underwent total laparoscopic radical resection of cardiac cancer + π-shaped esophageal jejunostomy and 34 patients underwent laparoscopic-assisted radical resection of cardiac cancer + Roux-en-Y esophago-jejunostomy. The safety and effects on stress response indicators of different surgical methods were analyzed. Results The mean operation time of the total endoscopy group was longer than that of the laparoscopic-assisted group and the length of the incision was significantly shorter than that in the laparoscopic-assisted group (P < 0.001). In terms of intraoperative bleeding, the amount of intraoperative bleeding in the total endoscopy group (130.26±23.54) mL was significantly lower than that in the laparoscopic group [(167.21±28.53) mL, t=6.017, P < 0.001]. The first postoperative exhaust time in the total endoscopy group was significantly lower than that in the laparoscopic-assisted group (P=0.003). There were no significant differences in extubation time, postoperative hospitalization days, postoperative complications, and number of surgically removed lymph nodes between the two groups (P>0.05). The serum level of CRP in the total endoscopy group was significantly lower than that in the laparoscopic-assisted group on the first and fifth day after surgery (P < 0.05). Conclusion Total laparoscopic radical resection of cardiac cancer + π esophagojejunostomy is safe, which can reduce intraoperative bleeding, shorten the recovery time of patients, relieve postoperative pain, greatly reduce the occurrence of postoperative complications, and has little effect on the body's traumatic stress response.
- Adenocarcinoma of esophagogastric junction,
- Total laparoscopic surgery,
- Total gastrectomy,
- π-shaped esophagojejunal,
- Traumatic stress

FullText(HTML)

References(24)

References

[1]	郭爱军, 鲁明典, 周波. 手助腹腔镜在胃癌根治术中的应用[J]. 中华全科医学, 2021, 19(7): 1099-1102. doi: 10.16766/j.cnki.issn.1674-4152.001994 GUO A J, LU M D, ZHOU B. The application of hand-assisted laparoscopic D2 radical gastrectomy[J]. Chinese Journal of General Practice, 2021, 19(7): 1099-1102. doi: 10.16766/j.cnki.issn.1674-4152.001994
[2]	JUNG K W, WON Y J, KONG H J, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2016[J]. Cancer Res Treat, 2019, 51(2): 417-430. doi: 10.4143/crt.2019.138
[3]	KAKEJI Y, ISHIKAWA T, SUZUKI S, et al. A retrospective 5-year survival analysis of surgically resected gastric cancer cases from the Japanese Gastric Cancer Association nationwide registry (2001-2013)[J]. Gastric Cancer, 2022, 25(6): 1082-1093. doi: 10.1007/s10120-022-01317-6
[4]	SHI Y, XU X H, ZHAO Y L, et al. Long-term oncologic outcomes of a randomized controlled trial comparing laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer[J]. Surgery, 2019, 165(6): 1211-1216. doi: 10.1016/j.surg.2019.01.003
[5]	卓恩挺, 王连臣, 符国宏, 等. 腹腔镜下腹会阴直肠癌手术中腹膜外造口与腹膜内造口的疗效比较[J]. 中国普通外科杂志, 2021, 30(2): 241-246. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ202102020.htm ZHUO E T, WANG L C, FU G H, et al. Efficacy comparison of extraperitoneal and intraperitoneal colostomy in laparoscopic abdominoperineal resection for rectal cancer[J]. Chinese Journal of General Surgery, 2021, 30(2): 241-246. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ202102020.htm
[6]	姚远, 方可, 张正君, 等. 食管空肠π吻合在全腹腔镜根治性全胃切除术中的应用[J]. 中国普通外科杂志, 2020, 29(10): 1204-1211. doi: 10.7659/j.issn.1005-6947.2020.10.007 YAO Y, FANG K, ZHANG Z J, et al. Application of π -shaped esophagojejunostomy in laparoscopic radical total gastrectomy[J]. Chinese Journal of General Surgery, 2020, 29(10): 1204-1211. doi: 10.7659/j.issn.1005-6947.2020.10.007
[7]	KANG S H, CHO Y S, MIN S H, et al. Intracorporeal esophagojejunostomy using a circular or a linear stapler in totally laparoscopic total gastrectomy: a propensity-matched analysis[J]. J Gastric Cancer, 2019, 19(2): 193-201. doi: 10.5230/jgc.2019.19.e17
[8]	MURAKAMI K, OBAMA K, TSUNODA S, et al. Linear or circular stapler A propensity score-matched, multicenter analysis of intracorporeal esophagojejunostomy following totally laparoscopic total gastrectomy[J]. Surg Endosc, 2020, 34(12): 5265-5273. doi: 10.1007/s00464-019-07313-9
[9]	XING J, XU K, LIU M, et al. Modified π-shaped esophagojejunostomy in totally laparoscopic total gastrectomy: a report of 40 consecutive cases from a single center[J]. J Int Med Res, 2022, 50(8): 3000605221116328. DOI: 10.1177/03000605221116328.
[10]	郭建, 孙康, 瞿建国, 等. 加速康复外科路径下腹腔镜全胃切除术后完全腹腔镜食管-空肠π吻合的临床疗效[J]. 中国普通外科杂志, 2022, 31(8): 1080-1088. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ202208011.htm GUO J, SUN K, QU J G, et al. Clinical efficacy of totally laparoscopic π-shaped esophagojejunostomy following laparoscopic gastrectomy under the enhanced recovery after surgery pathway[J]. Chinese Journal of General Surgery, 2022, 31(8): 1080-1088. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ202208011.htm
[11]	中华医学会外科学分会腹腔镜与内镜外科学组, 中国研究型医院学会机器人与腹腔镜外科专业委员会. 腹腔镜胃癌手术操作指南(2016版)[J]. 中华消化外科杂志, 2016, 15(9): 851-857. doi: 10.3760/cma.j.issn.1673-9752.2016.09.001 Section of Laparoscopic & Endoscopic Surgery, Branch of Surgery, Chinese Medical Association; Robotic and Laparoscopic Surgery Committee of Chines Research Hospital Association. Guideline for laparoscopic gastrectomy for gastric cancer(2016 edition)[J]. Chinese Journal of Digestive Surgery, 2016, 15(9): 851-857. doi: 10.3760/cma.j.issn.1673-9752.2016.09.001
[12]	季刚, 卫江鹏, 李世森, 等. 腹腔镜胃癌手术中高位食管空肠吻合重点与难点[J]. 中国实用外科杂志, 2023, 43(9): 997-1001. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK202309006.htm JI G, WEI J P, LI S S, et al. Key points and difficulties of high esophagojejunal anastomosis in laparoscopic gastrectomy for gastric cancer[J]. Chinese Journal of Practical Surgery, 2023, 43(9): 997-1001. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK202309006.htm
[13]	严东羿, 张顺, 袁彪, 等. 完全腹腔镜与腔镜辅助根治性全胃切除术的短期疗效对比[J]. 中国肿瘤外科杂志, 2021, 13(3): 261-266. doi: 10.3969/j.issn.1674-4136.2021.03.013 YAN D Y, ZHANG S, YUAN B, et al. Comparison of short-term efficacy between 3D totally laparoscopic and laparoscopy-assisted radical total gastrectomy[J]. Chinese Journal of Surgical Oncology, 2021, 13(3): 261-266. doi: 10.3969/j.issn.1674-4136.2021.03.013
[14]	冯志刚, 杨雨民. 胃癌患者微创全胃切除的手术效果研究[J]. 中国内镜杂志, 2018, 24(7): 51-55. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201807011.htm FENG Z G, YANG Y M. Effect of laparoscopic total gastrectomy in patients with gastric cancer[J]. China Journal of Endoscopy, 2018, 24(7): 51-55. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201807011.htm
[15]	黄昌明, 郑朝辉, 陆俊. 完全腹腔镜胃癌手术消化道重建专家共识及手术操作指南(2018版)[J]. 中国实用外科杂志, 2018, 38(8): 833-839. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201808001.htm HUANG C M, ZHENG C H, LU J. Expert consensus and surgical guidelines for digestive tract reconstruction in complete laparoscopic surgery for gastric cancer (2018 edition)[J]. Chinese Journal of Practical Surgery, 2018, 38(8): 833-839. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201808001.htm
[16]	汪兵, 夏亚斌, 张义胜, 等. 全腹腔镜全胃切除术食管空肠吻合术反穿刺法与Overlap法的比较[J]. 中国微创外科杂志, 2020, 20(7): 590-594. doi: 10.3969/j.issn.1009-6604.2020.07.004 WANG B, XIA Y B, ZHANG Y S, et al. Comparative analysis of reverse puncture device and overlap methods of esophagojejunostomy in totally laparoscopic total gastrectomy[J]. Chinese Journal of Minimally Invasive Surgery, 2020, 20(7): 590-594. doi: 10.3969/j.issn.1009-6604.2020.07.004
[17]	李胜, 杨文光, 樊林. 捆绑式反穿刺法食管空肠吻合技术在腹腔镜胃癌根治术中的应用[J]. 中国普通外科杂志, 2019, 28(10): 1197-1204. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201910007.htm LI S, YANG W G, FAN L. Application of tied reverse puncture esophagojejunostomy in laparoscopic radical gastrectomy for gastric cancer[J]. Chinese Journal of General Surgery, 2019, 28(10): 1197-1204. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201910007.htm
[18]	何子锐, 臧潞. 食管胃结合部腺癌腹腔镜手术消化道重建方式的进展[J]. 中国普通外科杂志, 2021, 30(10): 1127-1132. doi: 10.7659/j.issn.1005-6947.2021.10.001 HE Z R, ZANG L. Advances in laparoscopic digestive tract reconstruction for adenocarcinoma of the esophagogastric junction[J]. Chinese Journal of General Surgery, 2021, 30(10): 1127-1132. doi: 10.7659/j.issn.1005-6947.2021.10.001
[19]	JEONG O, JUNG M R, KANG J H, et al. Reduced anastomotic complications with intracorporeal esophagojejunostomy using endo-scopic linear staplers (overlap method) in laparoscopic totalgastrectomy for gastric carcinoma[J]. Surg Endosc, 2020, 34(5): 2313-2320. doi: 10.1007/s00464-019-07362-0
[20]	龚帅, 张蓬波, 张冲, 等. 食管空肠π形吻合在完全腹腔镜全胃切除术中的应用[J]. 中国普外基础与临床杂志, 2021, 28(9): 1188-1192. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL202109008.htm GONG S, ZHANG P B, ZHANG C, et al. Application of π-shaped esophagojejunal anastomosis in totally laparoscopic total gastrectomy[J]. Chinese Journal of Bases and Clinics in General Surgery, 2021, 28(9): 1188-1192. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL202109008.htm
[21]	ZHANG S, KHALIQ J, LI D, et al. Robotic total gastrectomy with π-shaped esophagojejunostomy using a linear stapler as a novel technique[J]. World J Surg Oncol, 2018, 16(1): 238. DOI: 10.1186/s12957-018-1542-z.
[22]	韦明光, 王楠, 吴涛, 等. 食管空肠overlap与π形吻合术后短期疗效及患者生活质量的对比研究[J]. 中国普通外科杂志, 2019, 28(4): 407-416. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201904006.htm WEI M G, WANG N, WU T, et al. Overlap versus π-shaped esophagojejunostomy: a comparative study of short-term results and patients' quality of life[J]. Chinese Journal of General Surgery, 2019, 28(4): 407-416. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201904006.htm
[23]	龚佑红, 吴艳烈. 食管空肠π形吻合术在完全3D腹腔镜下根治性全胃切除术中的应用[J]. 临床外科杂志, 2022, 30(7): 649-652. doi: 10.3969/j.issn.1005-6483.2022.07.015 GONG Y H, WU Y L. Application of complete 3D laparoscopic modified π-shaped esophagojejunostomy in radical total gastrectomy[J]. Journal of Clinical Surgery, 2022, 30(7): 649-652. doi: 10.3969/j.issn.1005-6483.2022.07.015
[24]	WANG Y, LIU Z, SHAN F, et al. Short-term outcomes after totally laparoscopic total gastrectomy with esophagojejunostomy constructed by π-shaped method versus overlap method[J]. J Surg Oncol, 2021, 124(8): 1329-1337. doi: 10.1002/jso.26642

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(1) / Tables(5)

Get Citation

PDF

XML

Article Metrics

Article views (112) PDF downloads(6)

Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction

doi: 10.16766/j.cnki.issn.1674-4152.003543

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Short term safety research of total laparoscopic π-shaped esophagojejunal anastomosis in radical surgery for adenocarcinoma of esophagogastric junction

doi: 10.16766/j.cnki.issn.1674-4152.003543

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content