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Erschienen in: Surgical Endoscopy 11/2017

13.04.2017

Comparison of OrVil™ and RPD in laparoscopic total gastrectomy for gastric cancer

verfasst von: Xi Li, Liang Hong, Dan Ding, Yaping Liu, Gengming Niu, Liang Li, Xin Wang, Xiaomei Li, Chongwei Ke

Erschienen in: Surgical Endoscopy | Ausgabe 11/2017

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Abstract

Background

Laparoscopic total gastrectomy (LTG) is frequently performed for treating patients with gastric cancer; however, the absence of anastomotic techniques with greater superiority has impaired its popularization. We have compared two types of anastomotic techniques with regard to technical perspectives and clinical outcomes.

Methods

We reviewed 43 patients with gastric cancer who underwent LTG. Two types of anastomotic techniques have been applied after LTG—the trans-orally inserted anvil (OrVil™) and the reverse puncture device (RPD). Data on the type of anastomosis, blood loss, operation time, anastomosis time, location of tumors, distance between the top border of tumors and top resection margin, diameter of tumor, length of postoperative hospital stay, early and late postoperative complications, and total cost of surgical consumables were obtained by reviewing patient medical records and analyzed thereafter.

Results

We included 32 men and 11 women (mean age 61 years). The loss to follow-up rate was 13.2%. The median survival time for the OrVil™ and RPD groups was 23 and 22 months, respectively. The total rate of complications was 9.3%. The difference in the anastomosis times between the groups was statistically significant. OrVil™ required more time than RPD and cost more than RPD.

Conclusions

Both the OrVil™ and RPD techniques showed good safety and applicability in LTG. RPD showed an advantage with regard to lesser operative complexity and lower cost.
Literatur
1.
Zurück zum Zitat Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234CrossRefPubMed Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234CrossRefPubMed
2.
Zurück zum Zitat Okabe H, Tsunoda S, Tanaka E, Hisamori S, Kawada H, Sakai Y (2015) Is laparoscopic total gastrectomy a safe operation? A review of various anastomotic techniques and their outcomes. Surg Today 45:549–558CrossRefPubMed Okabe H, Tsunoda S, Tanaka E, Hisamori S, Kawada H, Sakai Y (2015) Is laparoscopic total gastrectomy a safe operation? A review of various anastomotic techniques and their outcomes. Surg Today 45:549–558CrossRefPubMed
3.
Zurück zum Zitat Shim JH, Yoo HM, Oh SI, Nam MJ, Jeon HM, Park CH, Song KY (2013) Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 16:420–427CrossRefPubMed Shim JH, Yoo HM, Oh SI, Nam MJ, Jeon HM, Park CH, Song KY (2013) Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer. Gastric Cancer 16:420–427CrossRefPubMed
4.
Zurück zum Zitat Liao GQ, Ou XW, Liu SQ, Zhang SR, Huang W (2013) Laparoscopy-assisted total gastrectomy with trans-orally inserted anvil (OrVil): a single institution experience. World J Gastroenterol 19:755–760CrossRefPubMedPubMedCentral Liao GQ, Ou XW, Liu SQ, Zhang SR, Huang W (2013) Laparoscopy-assisted total gastrectomy with trans-orally inserted anvil (OrVil): a single institution experience. World J Gastroenterol 19:755–760CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Chong-Wei K, Dan-Lei C, Dan D (2013) A modified technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy. Surg Laparosc Endosc Percutaneous Tech 23:e109–e115CrossRef Chong-Wei K, Dan-Lei C, Dan D (2013) A modified technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy. Surg Laparosc Endosc Percutaneous Tech 23:e109–e115CrossRef
6.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Association JGC (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef Association JGC (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef
8.
Zurück zum Zitat Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed
9.
Zurück zum Zitat Chen D, Cheng P, Ding D, Ke Z (2014) Feasibility and safety of a novel reverse puncture device (RPD) for laparoscopic esophagogastrostomy/esophagojejunostomy. Int J Clin Exp Med 7:2497–2503PubMedPubMedCentral Chen D, Cheng P, Ding D, Ke Z (2014) Feasibility and safety of a novel reverse puncture device (RPD) for laparoscopic esophagogastrostomy/esophagojejunostomy. Int J Clin Exp Med 7:2497–2503PubMedPubMedCentral
10.
Zurück zum Zitat Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23:2624–2630CrossRefPubMed Jeong O, Park YK (2009) Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc 23:2624–2630CrossRefPubMed
11.
Zurück zum Zitat Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, Park SM (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442CrossRefPubMed Kim JJ, Song KY, Chin HM, Kim W, Jeon HM, Park CH, Park SM (2008) Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc 22:436–442CrossRefPubMed
12.
Zurück zum Zitat Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, Yano M, Monden M (2005) A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today 35:896–899CrossRefPubMed Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, Yano M, Monden M (2005) A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today 35:896–899CrossRefPubMed
13.
Zurück zum Zitat Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11:233–237CrossRefPubMed Usui S, Nagai K, Hiranuma S, Takiguchi N, Matsumoto A, Sanada K (2008) Laparoscopy-assisted esophagoenteral anastomosis using endoscopic purse-string suture instrument “Endo-PSI (II)” and circular stapler. Gastric Cancer 11:233–237CrossRefPubMed
14.
Zurück zum Zitat Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y (2009) Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 23:2167–2171CrossRefPubMed Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y (2009) Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc 23:2167–2171CrossRefPubMed
15.
Zurück zum Zitat Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, Uyama I (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211:e25–e29CrossRefPubMed Inaba K, Satoh S, Ishida Y, Taniguchi K, Isogaki J, Kanaya S, Uyama I (2010) Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg 211:e25–e29CrossRefPubMed
16.
Zurück zum Zitat Kunisaki C, Makino H, Oshima T, Fujii S, Kimura J, Takagawa R, Kosaka T, Akiyama H, Morita S, Endo I (2011) Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy. Surg Endosc 25:1300–1305CrossRefPubMed Kunisaki C, Makino H, Oshima T, Fujii S, Kimura J, Takagawa R, Kosaka T, Akiyama H, Morita S, Endo I (2011) Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy. Surg Endosc 25:1300–1305CrossRefPubMed
17.
Zurück zum Zitat Marangoni G, Villa F, Shamil E, Botha AJ (2012) OrVil-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon. Surg Endosc 26:811–817CrossRefPubMed Marangoni G, Villa F, Shamil E, Botha AJ (2012) OrVil-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon. Surg Endosc 26:811–817CrossRefPubMed
18.
Zurück zum Zitat Xie JW, Huang CM, Zheng CH, Li P, Wang JB, Lin JX, Jun L (2013) A safe anastomotic technique of using the transorally inserted anvil (OrVil) in Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy for proximal malignant tumors of the stomach. World J Surg Oncol 11:256CrossRefPubMedPubMedCentral Xie JW, Huang CM, Zheng CH, Li P, Wang JB, Lin JX, Jun L (2013) A safe anastomotic technique of using the transorally inserted anvil (OrVil) in Roux-en-Y reconstruction after laparoscopy-assisted total gastrectomy for proximal malignant tumors of the stomach. World J Surg Oncol 11:256CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat LaFemina J, Vinuela EF, Schattner MA, Gerdes H, Strong VE (2013) Esophagojejunal reconstruction after total gastrectomy for gastric cancer using a transorally inserted anvil delivery system. Ann Surg Oncol 20:2975–2983CrossRefPubMed LaFemina J, Vinuela EF, Schattner MA, Gerdes H, Strong VE (2013) Esophagojejunal reconstruction after total gastrectomy for gastric cancer using a transorally inserted anvil delivery system. Ann Surg Oncol 20:2975–2983CrossRefPubMed
20.
Zurück zum Zitat Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197:e13–e17CrossRefPubMed Omori T, Oyama T, Mizutani S, Tori M, Nakajima K, Akamatsu H, Nakahara M, Nishida T (2009) A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy. Am J Surg 197:e13–e17CrossRefPubMed
21.
Zurück zum Zitat Salih AE, Bass GA, D’Cruz Y, Brennan RP, Smolarek S, Arumugasamy M, Walsh TN (2015) Extending the reach of stapled anastomosis with a prepared OrVil device in laparoscopic oesophageal and gastric cancer surgery. Surg Endosc 29:961–971CrossRefPubMed Salih AE, Bass GA, D’Cruz Y, Brennan RP, Smolarek S, Arumugasamy M, Walsh TN (2015) Extending the reach of stapled anastomosis with a prepared OrVil device in laparoscopic oesophageal and gastric cancer surgery. Surg Endosc 29:961–971CrossRefPubMed
22.
Metadaten
Titel
Comparison of OrVil™ and RPD in laparoscopic total gastrectomy for gastric cancer
verfasst von
Xi Li
Liang Hong
Dan Ding
Yaping Liu
Gengming Niu
Liang Li
Xin Wang
Xiaomei Li
Chongwei Ke
Publikationsdatum
13.04.2017
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 11/2017
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5554-5

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