Technique of Roux-en-Y reconstruction using overlap method after laparoscopic total gastrectomy for gastric cancer: 100 consecutively successful cases

Hidehiko Kitagami, Mamoru Morimoto, Kenichi Nakamura, Takahiro Watanabe, Yo Kurashima, Keisuke Nonoyama, Kaori Watanabe, Shiro Fujihata, Akira Yasuda, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: We have established a standard procedure for Roux-en-Y (RY) reconstruction in laparoscopic total gastrectomy (LTG) using esophagojejunostomy by the overlap method (OL). We report on our RY reconstruction technique and special approaches, and evaluate the usefulness of our reconstruction method based on the surgical results of 100 patients we have experienced to date. Methods: We performed LTG in 100 patients with gastric cancer. After total gastrectomy using five ports, the resected stomach was extracted through a small laparotomy. Through that, we performed sacrifice of the jejunum, Y limb anastomosis, creation of the lifted jejunum. As the OL, a side-to-side anastomosis of the lifted jejunum to the esophageal stump was laparoscopically performed using a linear stapler in an isoperistaltic direction, and the entry hole was closed with full-thickness suturing. The lifted jejunum was fixed with suture to the duodenal stump at a location where the esophagojejunostomy site was made linear, and the duodenal stump was buried. The mesenteric gap was laparoscopically closed with suture. Results: The median operative time in 100 patients undergoing LTG was 385 min, the median blood loss was 65 mL, and the median time required for the OL was 32 min. The mean hospitalization period was 10 days, and postoperative complications included bleeding requiring reoperation in one patient; other complications such as pancreatic fistula in five patients (5 %) were treated conservatively. No complication associated with anastomosis occurred. Conclusion: In RY reconstruction using the OL, there were no complications associated with the anastomosis site in 100 consecutive patients, such as anastomotic leak or stenosis, indicating that it is a very useful and safe reconstruction method.

Original languageEnglish
Pages (from-to)4086-4091
Number of pages6
JournalSurgical endoscopy
Volume30
Issue number9
DOIs
Publication statusPublished - 01-09-2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

Fingerprint Dive into the research topics of 'Technique of Roux-en-Y reconstruction using overlap method after laparoscopic total gastrectomy for gastric cancer: 100 consecutively successful cases'. Together they form a unique fingerprint.

  • Cite this

    Kitagami, H., Morimoto, M., Nakamura, K., Watanabe, T., Kurashima, Y., Nonoyama, K., Watanabe, K., Fujihata, S., Yasuda, A., Yamamoto, M., Shimizu, Y., & Tanaka, M. (2016). Technique of Roux-en-Y reconstruction using overlap method after laparoscopic total gastrectomy for gastric cancer: 100 consecutively successful cases. Surgical endoscopy, 30(9), 4086-4091. https://doi.org/10.1007/s00464-015-4724-6