Modified Overlap Method for Esophagojejunostomy in Totally Laparoscopic Total Gastrectomy: A retrospective study of a single center

Abstract

AbstractPurposeThis retrospective study aims to investigate the value of the application of the modified overlap method for esophagojejunostomy in totally laparoscopic total gastrectomy (TLTG).MethodsFrom January 2017 to June 2020, 115 patients underwent the modified overlap method for esophagojejunostomy with intracorporeal anastomoses in TLTG. The patients’ data were collected prospectivelyand reviewed retrospectively.ResultsAll of 115 cases underwent TLTG and the modified overlap method for esophagojejunostomy. There were neither conversions to open surgery nor intraoperative complications. In this study, the median operative time was 201 (166–242) min and the median time of esophagojejunostomy was 27 (24–41) min. The estimated blood loss (EBL), time of fluid diet intake and length of postoperative hospital stay were 75 mL (range 50-120 mL), 4 (3–5) days, and 10 (9–13) days. The mean lymph node harvest was 23 (18–31). Anastomotic leak occurred postoperatively on three patients (2.6%). After a short-term follow-up, no anastomotic stenosis was encountered by endoscopy.ConclusionsTLTG with modified overlap method for esophagojejunostomy could be technically feasible and safe in upper gastric cancer patients. It has an acceptable range of postoperative complications, and it is effective in preventing anastomotic stenosis.