Intrathoracic esophagojejunostomy using OrVil^(TM) for gastric adenocarcinoma involving the esophagus  

作　　者：Kazuhito Yajima Tatsuo Ka Shin-ichi Kosugi Yosuke Kano Takashi Ishikawa Hiroshi Ichikawa Takaaki Hanyu Toshifumi Wakai 

机构地区：[1]Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences

出　　处：《World Journal of Gastrointestinal Surgery》2014年第12期235-240,共6页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV il^(TM). METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV il^(TM)was inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min(range; 210-367 min), and median blood loss was 210 mL(range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3(range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d(range: 15-20 d). The median length of esophageal involvement was 14 mm(range: 6-48 mm) and that of the resected esophagus was 40 mm(range: 35-55 mm); all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV ilTM. METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV ilTMwas inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min（range; 210-367 min）, and median blood loss was 210 mL（range; 100-838 mL）. The median numbers of dissected lower mediastinal nodes were 3（range; 1-10）. None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d（range: 15-20 d）. The median length of esophageal involvement was 14 mm（range: 6-48 mm） and that of the resected esophagus was 40 mm（range: 35-55 mm）; all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.

关 键 词：Gastric cancer Esophageal invasion Lower mediastinal lymphadenectomy Or Vil^(TM) Intrathoracic anastomosis 

分 类 号：R735.33[医药卫生—肿瘤]