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. 腔腹鏡下胃癌根治術在早期胃癌患者中的治療效果分析. 中華普外科手術學雜志: 電子版, 2018, 12(4): 312-314.
3.	單毓強, 鄭斯鑫, 朱阿考, 等. 完全腹腔鏡根治性全胃切除術中淋巴結清掃和消化道重建應用總結. 中華腔鏡外科雜志: 電子版, 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.	陳新華, 羅俊, 朱煜, 等. 腹腔鏡全胃切除經口抵釘座置入裝置腔內食管-空腸吻合與傳統輔助切口吻合安全性對比的傾向得分匹配分析. 中華胃腸外科雜志, 2018, 21(8): 887-895.
7.	王驥, 張沖, 張秀忠, 等. 經口輸送釘砧系統在腹腔鏡胃癌根治術中的應用. 中華普通外科雜志, 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.	朱宇瀟, 王驥, 馬紅欽, 等. 完全腹腔鏡下肝門部膽管癌根治術 14 例經驗總結. 中國普外基礎與臨床雜志, 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.	所劍, 李國新, 蘇向前, 等. 全腹腔鏡全胃切除術消化道重建方式選擇—圓形還是側側吻合? 中國實用外科雜志, 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.	王偉, 鄭燕生, 熊文俊, 等. 腹腔鏡全胃切除術后不同食管空腸吻合方法臨床應用探討. 中國實用外科雜志, 2016, 36(9): 981-984.
18.	馬學強, 顧利虎, 江克翔, 等. 經口置入釘砧頭系統(OrVil^TM)在全胃切除消化道重建中的應用. 中華胃腸外科雜志, 2018, 21(7): 822-825.
19.	蘇向前, 姚震旦. 全腹腔鏡全胃切除術食管空腸器械吻合技術難點及對策. 中國實用外科雜志, 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.	羅俊, 陳新華, 陳粵泓, 等. 腹腔鏡全胃切除術后食管空腸吻合口漏危險因素分析. 中國實用外科雜志, 2019, 39(2): 168-172.
24.	王向征, 趙宗耀, 張會來, 等. 淋巴結清掃范圍對進展期胃癌患者預后的影響研究. 癌癥進展, 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. 腔腹鏡下胃癌根治術在早期胃癌患者中的治療效果分析. 中華普外科手術學雜志: 電子版, 2018, 12(4): 312-314.
3. 單毓強, 鄭斯鑫, 朱阿考, 等. 完全腹腔鏡根治性全胃切除術中淋巴結清掃和消化道重建應用總結. 中華腔鏡外科雜志: 電子版, 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. 陳新華, 羅俊, 朱煜, 等. 腹腔鏡全胃切除經口抵釘座置入裝置腔內食管-空腸吻合與傳統輔助切口吻合安全性對比的傾向得分匹配分析. 中華胃腸外科雜志, 2018, 21(8): 887-895.
7. 王驥, 張沖, 張秀忠, 等. 經口輸送釘砧系統在腹腔鏡胃癌根治術中的應用. 中華普通外科雜志, 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. 朱宇瀟, 王驥, 馬紅欽, 等. 完全腹腔鏡下肝門部膽管癌根治術 14 例經驗總結. 中國普外基礎與臨床雜志, 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. 所劍, 李國新, 蘇向前, 等. 全腹腔鏡全胃切除術消化道重建方式選擇—圓形還是側側吻合? 中國實用外科雜志, 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. 王偉, 鄭燕生, 熊文俊, 等. 腹腔鏡全胃切除術后不同食管空腸吻合方法臨床應用探討. 中國實用外科雜志, 2016, 36(9): 981-984.
18. 馬學強, 顧利虎, 江克翔, 等. 經口置入釘砧頭系統(OrVil^TM)在全胃切除消化道重建中的應用. 中華胃腸外科雜志, 2018, 21(7): 822-825.
19. 蘇向前, 姚震旦. 全腹腔鏡全胃切除術食管空腸器械吻合技術難點及對策. 中國實用外科雜志, 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. 羅俊, 陳新華, 陳粵泓, 等. 腹腔鏡全胃切除術后食管空腸吻合口漏危險因素分析. 中國實用外科雜志, 2019, 39(2): 168-172.
24. 王向征, 趙宗耀, 張會來, 等. 淋巴結清掃范圍對進展期胃癌患者預后的影響研究. 癌癥進展, 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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