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- Title
Linear stapler anastomosis for esophagogastrostomy in laparoscopic proximal gastrectomy reduce reflux esophagitis.
- Authors
Sugita, Hirofumi; Sakuramoto, Shinichi; Oya, Shuichiro; Fujiwara, Naoto; Miyawaki, Yutaka; Satoh, Hiroshi; Okamoto, Kojun; Yamaguchi, Shigeki; Koyama, Isamu
- Abstract
Purpose: There are various reconstruction methods for Laparoscopic proximal gastrectomy (LPG), such as esophagogastrostomy (EG), double-tract reconstruction, and jejunal interposition. We have performed EG using a circular stapler (OrVil) from 2013 and using a linear stapler from 2017. The aim of this retrospective study was to clarify which stapler is better for EG for LPG. Methods: The data of 84 patients who underwent EG for LPG between January 2013 and September 2019 were analyzed. EG with fundoplication was done using a circular stapler (OrVil) in 45 patients (CS group) and a linear stapler in 39 patients (LS group). The patients' medical records were reviewed. Clinical symptoms were obtained by interview at each outpatient consultation. All patients underwent postoperative 1-year follow-up endoscopy. To minimize bias between the two groups, propensity scores were calculated using a logistic regression model. After propensity-score matching, 60 patients (30 in the CS group and 30 in the LS group) were studied. Results: Patient characteristics, operative outcomes were similar in two groups. Anastomotic leakage occurred in one patient (3.3%) in both groups. Anastomotic stenosis occurred in five patients (16.7%) in the CS group and two patients (6.7%) in the LS group. The rate of patients with severe reflux esophagitis (grade C or D) was significantly lower in the LS group (3.4%) than in the CS group (26.7%) (p = 0.026). Conclusions: EG with a linear stapler could reduce the risk of severe reflux esophagitis, and it could be a safe and feasible anastomosis for patients after LPG.
- Subjects
FUNDOPLICATION; GASTRECTOMY; LAPAROSCOPIC surgery; MEDICAL records; LOGISTIC regression analysis; GASTROESOPHAGEAL reflux; REGRESSION analysis; HIATAL hernia
- Publication
Langenbeck's Archives of Surgery, 2021, Vol 406, Issue 8, p2709
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s00423-021-02250-5