Laparoscopic Total Gastrectomy for Gastric Cancer

Abstract

Laparoscopic total gastrectomy (LTG) has been more widely performed in the last decade because of improvements in the techniques and safety of laparoscopic distal gastrectomy. However, due to its technical difficulty, there are still concerns regarding the safety of LTG. Meta-analyses have shown that LTG is technically feasible, safe, and may offer advantages over open total gastrectomy for treatment of gastric cancer. Various methods of performing esophagojejunostomy have been developed in an effort to decrease the rate of anastomosis-related complications, and have ultimately improved the safety and acceptance of LTG. However, there is still a lack of level-one evidence in support of LTG. Conduct of large-scale, randomized clinical trials will be needed in order to verify the safety and efficacy of LTG. Therefore, we reviewed the current status and some of the controversies surrounding LTG.

Left Dorsal Wall Anastomosis Compared with Parallel-Line Anastomosis for Intracorporeal Overlap Esophagojejunostomy during Laparoscopic Total Gastrectomy

“…However, numerous surgeons and researchers have contributed to developing different methods for intracorporeal esophagojejunostomy. [10][11][12][13][14][15] Specifically, introduction of a V-roc suture known as a barbed suture and development of a stapler for use in laparoscopic surgery marked a turning point in laparoscopic surgery. In 2016, a study published by Lee SW and his colleagues found that the safety of intracorporeal anastomosis was improved during laparoscopic surgery when using a linear stapler and barbed suture.…”