Laparoscopic Gastric Resection for Gastric Cancer: Is Intracorporeal Anastomosis Necessary?

  • Ogun Ersen Ankara University, Medicine Faculty, General Surgery/Clinic of Surgical Oncology https://orcid.org/0000-0001-7213-9122
  • Ali Ekrem Ünal Ankara University, Medicine Faculty, General Surgery/Clinic of Surgical Oncology
  • Cemil Yüksel Ankara University, Medicine Faculty, General Surgery/Clinic of Surgical Oncology
  • Serdar Çulcu Ankara Oncology Hospital, General Surgery Clinic
  • Salim İlksen Başçeken Diyarbakır Research Hospital, General Surgery Clinic
  • Ümit Mercan Ankara University, Medicine Faculty, General Surgery/Clinic of Surgical Oncology
  • Salim Demirci Ankara University, Medicine Faculty, General Surgery/Clinic of Surgical Oncology
Keywords: Stomach Neoplasms, Laparoscopy, Gastrectomy

Abstract

Background and Objective: In surgical dissection, laparoscopic approach and open techniques do not differ significantly, but there is still no consensus on how anastomosis should be performed in both cardia and distal gastric tumors. Anastomosis can be performed by laparoscopy-assisted mini-laparotomy or by intracorporeal suture techniques. In this study, we aim to present our four years of clinical experience and short-term surgical results from 133 cases in order to evaluate the necessity of laparoscopic anastomosis.

Methods: This study was approved by Ethics Committee (No: 1-8-19, date: 14/01/2019). Patients who underwent curative resection with the diagnosis of gastric adenocarcinoma between January 2014 and January 2018 in the Ankara University Surgical Oncology Department were included in the study.

Results: Of the 133 patients included in the study, 108 (81.2) were male and the mean age was 60.51 ± 12.0 years. The time of anastomosis was significantly longer in patients undergoing intracorporeal anastomosis (p = 0.021). The incidence of anastomotic leakage was significantly higher in the group undergoing intracorporeal anastomosis (p = 0.004).

Conclusions: We think that esophagojejunostomy and jejunojejunostomy anastomoses in patients undergoing total gastrectomy should be performed with intracorporeal techniques in terms of benefit risk assessment. We believe that it is more feasible to continue the case with mini laparotomy when anastomosis is reached in patients who are planned to have gastrojejunostomy. In addition, in terms of intracorporeal anastomoses and advanced laparoscopic techniques, intracorporeal anastomoses performed in gastric cancer surgery for a laparoscopist who has completed the learning curve do not appear to be very different in terms of anastomosis safety.

doi: https://doi.org/10.12669/pjms.36.6.1915

How to cite this:
Ogun E, Ekrem UA, Yuksel C, Serdar C, Basceken SI, Umit M, et al. Laparoscopic Gastric Resection for Gastric Cancer: Is Intracorporeal Anastomosis Necessary? Pak J Med Sci. 2020;36(6):1177-1182. doi: https://doi.org/10.12669/pjms.36.6.1915

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2020-08-19
How to Cite
Ersen, O., Ünal, A., Yüksel, C., Çulcu, S., Başçeken, S., Mercan, Ümit, & Demirci, S. (2020). Laparoscopic Gastric Resection for Gastric Cancer: Is Intracorporeal Anastomosis Necessary?. Pakistan Journal of Medical Sciences, 36(6). https://doi.org/10.12669/pjms.36.6.1915
Section
Original Articles