Application of transorally inserted anvi in laparoscopic total gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Quan , WANG Ji , MA Hongqin , LIU Li , DU Yusheng ,  ZHAO Wenxing

Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P. R. China;

Corresponding author：

ZHAO Wenxing, Email: wxzhao@sina.com

Keywords：

gastric cancer; OrVil^TM; laparoscopic total gastrectomy; esophagojejunostomy

DOI：

10.7507/1007-9424.202002015

Video：

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Objective To evaluate the safety and efficacy of transorally inserted anvil (OrVil^TM) for laparoscopic total gastrectomy compared with open total gastrectomy.Methods Retrospectively summarized the 285 gastric cancer patients from the Affiliated Hospital of Xuzhou Medical University between December 2012 and April 2018, of them 156 patients underwent laparoscopic total gastrectomy (being reconstructed by OrVil^TM) via 129 patients underwent open total gastrectomy. Operation-associated parameters and postoperative complications were compared between the two groups.Results The intraoperative blood loss was significantly less, proximal resection margin was significantly longer, and first ambulatory time, time to first flatus, time to fluid diet were significantly shorter in the laparoscopic total gastrectomy group (P<0.05). Whereas the total operative time, esophagojejunostomy time, numbers of dissected lymph nodes, time to remove drainage tube, length of postoperative hospital stay, and morbidity of postoperative complication (including anastomotic leakage, anastomotic stenosis, anastomotic bleeding, celiac and pleural effusion or infection) were not significantly different between the two groups (P>0.05).Conclusion OrVil^TM is a technically safe and feasible surgical procedure for esophagojejunostomy in laparoscopic total gastrectomy.

Citation： SUN Quan, WANG Ji, MA Hongqin, LIU Li, DU Yusheng, ZHAO Wenxing. Application of transorally inserted anvi in laparoscopic total gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1403-1407. doi: 10.7507/1007-9424.202002015 Copy

1.	Liu K, Yang K, Zhang W, et al. Changes of esophagogastric junctional adenocarcinoma and gastroesophageal reflux disease among surgical patients during 1988-2012: a single-institution, high-volume experience in China. Ann Surg, 2016, 263(1): 88-95.
2.	董志毅. 腔腹镜下胃癌根治术在早期胃癌患者中的治疗效果分析. 中华普外科手术学杂志: 电子版, 2018, 12(4): 312-314.
3.	单毓强, 郑斯鑫, 朱阿考, 等. 完全腹腔镜根治性全胃切除术中淋巴结清扫和消化道重建应用总结. 中华腔镜外科杂志: 电子版, 2019, 12(6): 342-346.
4.	Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc, 2009, 23(11): 2624-2630.
5.	Lu X, Hu Y, Liu H, et al. Short-term outcomes of intracorporeal esophagojejunostomy using the transorally inserted anvil versus extracorporeal circular anastomosis during laparoscopic total gastrectomy for gastric cancer: a propensity score matching analysis. J Surg Res, 2016, 200(2): 435-443.
6.	陈新华, 罗俊, 朱煜, 等. 腹腔镜全胃切除经口抵钉座置入装置腔内食管-空肠吻合与传统辅助切口吻合安全性对比的倾向得分匹配分析. 中华胃肠外科杂志, 2018, 21(8): 887-895.
7.	王骥, 张冲, 张秀忠, 等. 经口输送钉砧系统在腹腔镜胃癌根治术中的应用. 中华普通外科杂志, 2014, 29(6): 433-436.
8.	Kawaguchi Y, Fuks D, Kokudo N, et al. Difficulty of laparoscopic liver resection: proposal for a new classification. Ann Surg, 2018, 267(1): 13-17.
9.	Wang KX, Cheng ZQ, Liu Z, et al. Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer. World J Gastroenterol, 2018, 24(32): 3671-3676.
10.	Kantor O, Talamonti MS, Sharpe S, et al. Laparoscopic pancreaticoduodenectomy for adenocarcinoma provides short-term oncologic outcomes and long-term overall survival rates similar to those for open pancreaticoduodenectomy. Am J Surg, 2017, 213(3): 512-515.
11.	朱宇潇, 王骥, 马红钦, 等. 完全腹腔镜下肝门部胆管癌根治术 14 例经验总结. 中国普外基础与临床杂志, 2019, 26(1): 56-60.
12.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
13.	Inaba K, Satoh S, Ishida Y, et al. Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg, 2010, 211(6): e25-e29.
14.	所剑, 李国新, 苏向前, 等. 全腹腔镜全胃切除术消化道重建方式选择—圆形还是侧侧吻合? 中国实用外科杂志, 2016, 36(9): 955-957.
15.	Beyer K, Baukloh AK, Kamphues C, et al. Laparoscopic versus open gastrectomy for locally advanced gastric cancer: a systematic review and meta-analysis of randomized controlled studies. World J Surg Oncol, 2019, 17(1): 68.
16.	Shi Y, Li L, Xiao H, et al. Feasibility of laparoscopic gastrectomy for patients with Siewert-type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction: a propensity score matching analysis. PLoS One, 2018, 13(9): e0203125.
17.	王伟, 郑燕生, 熊文俊, 等. 腹腔镜全胃切除术后不同食管空肠吻合方法临床应用探讨. 中国实用外科杂志, 2016, 36(9): 981-984.
18.	马学强, 顾利虎, 江克翔, 等. 经口置入钉砧头系统(OrVil^TM)在全胃切除消化道重建中的应用. 中华胃肠外科杂志, 2018, 21(7): 822-825.
19.	苏向前, 姚震旦. 全腹腔镜全胃切除术食管空肠器械吻合技术难点及对策. 中国实用外科杂志, 2016, 36(9): 945-948.
20.	Shida A, Mitsumori N, Fujioka S, et al. Comparison of short-term and long-term clinical outcomes between laparoscopic and open total gastrectomy for patients with gastric cancer. Surg Laparosc Endosc Percutan Tech, 2016, 26(4): 319-323.
21.	Kawamura H, Ohno Y, Ichikawa N, et al. Anastomotic complications after laparoscopic total gastrectomy with esophagojejunostomy constructed by circular stapler (OrVil). Surg Endosc, 2017, 31(12): 5175-5182.
22.	Xie JW, Huang CM, Zheng CH, et al. 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, 2013, 11: 256.
23.	罗俊, 陈新华, 陈粤泓, 等. 腹腔镜全胃切除术后食管空肠吻合口漏危险因素分析. 中国实用外科杂志, 2019, 39(2): 168-172.
24.	王向征, 赵宗耀, 张会来, 等. 淋巴结清扫范围对进展期胃癌患者预后的影响研究. 癌症进展, 2019, 17(8): 929-932.
25.	Ilhan E, Ureyen O, Meral UM. Ongoing problems concerning 7th TNM staging system and proposals for 8th TNM staging system of gastric cancer. Prz Gastroenterol, 2016, 11(4): 223-225.

1. Liu K, Yang K, Zhang W, et al. Changes of esophagogastric junctional adenocarcinoma and gastroesophageal reflux disease among surgical patients during 1988-2012: a single-institution, high-volume experience in China. Ann Surg, 2016, 263(1): 88-95.
2. 董志毅. 腔腹镜下胃癌根治术在早期胃癌患者中的治疗效果分析. 中华普外科手术学杂志: 电子版, 2018, 12(4): 312-314.
3. 单毓强, 郑斯鑫, 朱阿考, 等. 完全腹腔镜根治性全胃切除术中淋巴结清扫和消化道重建应用总结. 中华腔镜外科杂志: 电子版, 2019, 12(6): 342-346.
4. Jeong O, Park YK. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc, 2009, 23(11): 2624-2630.
5. Lu X, Hu Y, Liu H, et al. Short-term outcomes of intracorporeal esophagojejunostomy using the transorally inserted anvil versus extracorporeal circular anastomosis during laparoscopic total gastrectomy for gastric cancer: a propensity score matching analysis. J Surg Res, 2016, 200(2): 435-443.
6. 陈新华, 罗俊, 朱煜, 等. 腹腔镜全胃切除经口抵钉座置入装置腔内食管-空肠吻合与传统辅助切口吻合安全性对比的倾向得分匹配分析. 中华胃肠外科杂志, 2018, 21(8): 887-895.
7. 王骥, 张冲, 张秀忠, 等. 经口输送钉砧系统在腹腔镜胃癌根治术中的应用. 中华普通外科杂志, 2014, 29(6): 433-436.
8. Kawaguchi Y, Fuks D, Kokudo N, et al. Difficulty of laparoscopic liver resection: proposal for a new classification. Ann Surg, 2018, 267(1): 13-17.
9. Wang KX, Cheng ZQ, Liu Z, et al. Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer. World J Gastroenterol, 2018, 24(32): 3671-3676.
10. Kantor O, Talamonti MS, Sharpe S, et al. Laparoscopic pancreaticoduodenectomy for adenocarcinoma provides short-term oncologic outcomes and long-term overall survival rates similar to those for open pancreaticoduodenectomy. Am J Surg, 2017, 213(3): 512-515.
11. 朱宇潇, 王骥, 马红钦, 等. 完全腹腔镜下肝门部胆管癌根治术 14 例经验总结. 中国普外基础与临床杂志, 2019, 26(1): 56-60.
12. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
13. Inaba K, Satoh S, Ishida Y, et al. Overlap method: novel intracorporeal esophagojejunostomy after laparoscopic total gastrectomy. J Am Coll Surg, 2010, 211(6): e25-e29.
14. 所剑, 李国新, 苏向前, 等. 全腹腔镜全胃切除术消化道重建方式选择—圆形还是侧侧吻合? 中国实用外科杂志, 2016, 36(9): 955-957.
15. Beyer K, Baukloh AK, Kamphues C, et al. Laparoscopic versus open gastrectomy for locally advanced gastric cancer: a systematic review and meta-analysis of randomized controlled studies. World J Surg Oncol, 2019, 17(1): 68.
16. Shi Y, Li L, Xiao H, et al. Feasibility of laparoscopic gastrectomy for patients with Siewert-type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction: a propensity score matching analysis. PLoS One, 2018, 13(9): e0203125.
17. 王伟, 郑燕生, 熊文俊, 等. 腹腔镜全胃切除术后不同食管空肠吻合方法临床应用探讨. 中国实用外科杂志, 2016, 36(9): 981-984.
18. 马学强, 顾利虎, 江克翔, 等. 经口置入钉砧头系统(OrVil^TM)在全胃切除消化道重建中的应用. 中华胃肠外科杂志, 2018, 21(7): 822-825.
19. 苏向前, 姚震旦. 全腹腔镜全胃切除术食管空肠器械吻合技术难点及对策. 中国实用外科杂志, 2016, 36(9): 945-948.
20. Shida A, Mitsumori N, Fujioka S, et al. Comparison of short-term and long-term clinical outcomes between laparoscopic and open total gastrectomy for patients with gastric cancer. Surg Laparosc Endosc Percutan Tech, 2016, 26(4): 319-323.
21. Kawamura H, Ohno Y, Ichikawa N, et al. Anastomotic complications after laparoscopic total gastrectomy with esophagojejunostomy constructed by circular stapler (OrVil). Surg Endosc, 2017, 31(12): 5175-5182.
22. Xie JW, Huang CM, Zheng CH, et al. 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, 2013, 11: 256.
23. 罗俊, 陈新华, 陈粤泓, 等. 腹腔镜全胃切除术后食管空肠吻合口漏危险因素分析. 中国实用外科杂志, 2019, 39(2): 168-172.
24. 王向征, 赵宗耀, 张会来, 等. 淋巴结清扫范围对进展期胃癌患者预后的影响研究. 癌症进展, 2019, 17(8): 929-932.
25. Ilhan E, Ureyen O, Meral UM. Ongoing problems concerning 7th TNM staging system and proposals for 8th TNM staging system of gastric cancer. Prz Gastroenterol, 2016, 11(4): 223-225.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of transorally inserted anvi in laparoscopic total gastrectomy

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