Abstract
Laparoscopic esophagojejunostomy is a challenging procedure because of its technical difficulty. We herein report a new method involving circular-stapled anastomosis using a hand-sewn suture with four stay-sutures and evaluate its outcomes. Esophagojejunostomy using this method was performed in 36 consecutive patients with clinical stage I gastric cancer at the authors’ institutions. The key feature of our procedure was the placement of four full-thickness stay-sutures to anchor the esophageal stump prior to the hand-sewn purse-string suture. The median operation time and mean anvil fixation time were 315.5 and 21.9 min, respectively. The mortality rate was 0%, although anastomotic leakage following esophagojejunostomy was observed in 1 patient (2.8%), and anastomotic stenosis was observed in another patient (2.8%). Intracorporeal esophagojejunostomy using the four stay-sutures method appears to be safe and feasible. We believe that this method enables hand-sewn purse-string suturing to be performed more easily.
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This study was approved by the ethics committee of Japan Community Healthcare Organization Gunma Central Hospital and Gunma Prefectural Cancer Center and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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All patients provided their informed consent for laparoscopic total gastrectomy prior to surgery.
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Sano, A., Ojima, H., Ogawa, A. et al. Four stay-sutures method: a simplified hand-sewn purse-string suture in laparoscopic circular-stapled esophagojejunostomy. Surg Today 50, 314–319 (2020). https://doi.org/10.1007/s00595-019-01867-w
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DOI: https://doi.org/10.1007/s00595-019-01867-w