Double stapling technique versus hemi-double stapling technique for esophagojejunostomy with OrVil™ after laparoscopic total gastrectomy: a single-blind, randomized clinical trial

Yamauchi, Suguru; Kanda, Seiichi; Yoshimoto, Yutaro; Kubota, Akira; Tsuda, Kenki; Yube, Yukinori; Kaji, Shuichiro; Oka, Shinichi; Orita, Hajime; Brock, Malcolm V.; Mine, Shinji; Fukunaga, Tetsu

doi:10.1007/s00464-023-10068-z

Cited by 3 publications

(3 citation statements)

References 55 publications

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“…A wide variety of intracorporeal anastomosis techniques have been developed and can be performed manually or with a stapler. Double stapling and hemi-double stapling techniques are techniques using double staplers without a need for purse-string suture and with ease of application [ 22 , 36 , 37 , 38 ]. In the double stapling technique (DST), the rod of the anvil is located at the centre of the linear staple line.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, fibrosis at the crossing points may lead to anastomotic stenosis [ 13 , 38 , 39 ]. Yamauchi et al [ 37 ] directly compared DST and HDST using OrVilTM through a randomised clinical trial. In their study, the intersection of the linear stapler and circular stapler, which was two locations in the DST group and one location in the HDST group, was reinforced in all cases with intracorporeal hand-sewn Lembert sutures.…”

Section: Discussionmentioning

confidence: 99%

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Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Senol,

Karagul

2024

JPM

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The hemidouble stapler technique (HDST) in laparoscopic intracorporeal esophagojejunostomy has aspects that pose risks to the safety of the anastomosis. We developed a new esophagojejunostomy technique that converts a double-stapled anastomosis to a single-stapled anastomosis in laparoscopic total gastrectomy (LTG). The aim of this study is to compare the results of two techniques. Patients who underwent LTG for gastric cancer in our hospital between October 2016 and May 2022 were included in the study. Patients were retrospectively reviewed in two groups: those who underwent HDST and the ghosting double stapling technique (GDST). Both groups were analysed in terms of demographics, perioperative findings, and postoperative outcomes. The GDST was used in 14 patients. The HDST was used on 16 patients. Two patients in the HDST group whose esophagojejunal anastomosis was not assessed on endoscopic imaging were excluded. The mean total operative times were 292.6 ± 43.7 and 224.3 ± 36.1 min (p < 0.001). The mean times for esophagojejunostomy were 38.6 ± 4.3 and 26.8 ± 6.4 min (p < 0.001). One case of anastomotic stenosis was observed in the HDST group. Anastomotic leakage was not observed in both groups. However, there was no significant difference in overall morbidity between the groups (p > 0.05). Both HDST and GDST can be safely performed in the esophagojejunostomy for LTG.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Senol,

Karagul

2024

JPM

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“…• The transorally inserted anvil (OrVil) is frequently selected for esophagojejunostomy after laparoscopic total gastrectomy because of its versatility. During anastomosis with OrVil, the double stapling technique or hemi-double stapling technique had similar AL rate, although only one AL of Clavien-Dindo classification grade ≥ IIIa was observed in the double stapling technique [65].…”

Section: Reconstruction Type Eso-jejuno-anastomosismentioning

confidence: 90%

Anastomotic Leakage after Gastrectomy for Gastric Cancer

Seicean,

Puscasu,

Gheorghiu

et al. 2023

JGLD

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Anastomotic leakage (AL) constitutes a prominent cause of significant morbidity following gastrectomy for gastric cancer. The manifestation of AL typically occurs within 7 to 10 days post-surgery, with reported incidence rates of 5.8-6.7% for open gastrectomy and 3.3-4.1% for laparoscopic gastrectomy. Various predisposing risk factors have been identified, including the individual nutritional status (excluding obesity) and preoperative corticotherapy. Interestingly, the administration of neoadjuvant therapies appears to reduce the AL occurrence. In the context of distal gastrectomies, the rates of AL are comparable between laparoscopic, robotic, and open approaches. The total gastrectomies have higher AL rate compared to distal gastrectomies, which are considered the preferred approach. Prophylactic drainage measures have not demonstrated efficacy in preventing AL. As for postoperative management, conservative treatment is indicated for patients presenting with mild clinical symptoms and increased inflammatory blood tests. This approach involves fasting, enteral or parenteral nutrition, administration of antibiotics, and percutaneous drainage. For small AL, endoscopic therapies such as stents, vacuum therapy, clips, suturing devices, and injections are appropriate treatment options. In cases of high-volume fistulas, severe sepsis or failure of previous therapies, surgical reoperation becomes the ultimate solution.

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The safety and feasibility assessment of overlap esophagojejunostomy with self-pulling and latter transection technique in totally laparoscopic total gastrectomy

Wang,

Liu,

Cui

et al. 2024

Journal of Gastrointestinal Surgery

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Double stapling technique versus hemi-double stapling technique for esophagojejunostomy with OrVil™ after laparoscopic total gastrectomy: a single-blind, randomized clinical trial

Cited by 3 publications

References 55 publications

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy

Anastomotic Leakage after Gastrectomy for Gastric Cancer

The safety and feasibility assessment of overlap esophagojejunostomy with self-pulling and latter transection technique in totally laparoscopic total gastrectomy

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