Intra-corporeal hand-sewn gastroduodenostomy in totally laparoscopic distal gastrectomy: Preliminary Experience with 21 Cases

Abstract

Purpose Various procedures of intra-corporeal gastroduodenostomy in totally laparoscopic distal gastrectomy(TLDG) have been devised, but an optimal method has not yet been standardized. Studies of intra-corporeal hand-sewn gastroduodenostomy in TLDG are limited. In this study, we present our experience of intra-corporeal hand-sewn gastroduodenostomy in TLDG. Methods From December 2018 to October 2021, 21 patients underwent TLDG using intra-corporeal hand-sewn gastroduodenostomy for gastric cancer. The data of the patient demographics, intraoperative variables, postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected. Results All patients were successfully operated on without conversion to open- or laparoscope-assisted surgery. The median operative time was 175 min (range, 152-240min), with a reconstruction duration of 21 min (range, 15- 34min) .The time until first flatus was 4 days (range,2-6d). The time to starting a soft diet was 7 days (range,3-16d). There were no anastomotic complications. The morbidity rate was 4.76% with one case of delayed gastric emptying. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 8 days(range,6-19d). Median follow-up time was 15 months (range,3-36m), no anastomotic strictures were encountered. Conclusions Intra-corporeal hand-sewn gastroduodenostomy in TLDG is a safe and feasible procedure. This method with lower surgical costs could be a good option for performing intracorporeal gastroduodenostomy with an advanced laparoscopic suture technique.

Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

“…Clinically, it has been found that there are various methods of anastomosis in colorectal resection [22][23][24][25] ,and the reconstruction method of overlapping triangular anastomosis [26] ,in peristalsis is more conducive to the recovery of digestive function [27] .Overlap is one of the most commonly used linear anastomosis methods by surgeons [5,28,29] ,but the choice depends on the surgeon's experience and bias. To better answer this question, we need to analyze the clinical outcomes of overlapping triangulation and other anastomosis procedures in terms of surgical e cacy.…”