Totally Laparoscopic Total Gastrectomy for Gastric Cancer at a Single Institutional Experience and Changes in Technique of Esophagojejunostomy

摘要: The totally laparoscopic total gastrectomy (TLTG) for gastric cancer has not gained widespread acceptance due to its technical difficulties, especially with the intracorporeal esophagojejunostomy (IEJS). Various modified procedures IEJS have been devised, but an optimal method yet standardized. A of 32 consecutive patients (23 men and 9 women) underwent TLTGs cancer, between December 2009 2014 at Iwate Medical University Hospital, were enrolled in this study. Here, we report our institution’s experience TLTGs, changes IEJS. study participants had a mean age 66.8 years body mass index 22.8 kg/m2. operation time blood loss 356.1 min 61.2 mL, respectively. According IEJS, there 6 circular stapler (CS) (single double stapling techniques) 26 linear (LS) (overlap technique functional end-to-end anastomosis) performed. Two patients, who undergone by technique, developed anastomotic stenosis required endoscopic balloon dilatations sites. Therefore, changed LS secure abundant diameter. In institute, some problematic complications procedure occurred introduction TLTG. We overcome these changing standardizing techniques, cultivating techniques.