| Purpose To evaluate the safety and flexibility of uncut Roux-en-Y esophagojejunostomy in totally laparoscopic total gastrectomy(TLTG).Methods Between July 2016 to December 2016,15 patients(Group A)received totally laparoscopic total gastrectomy plus uncut Roux-en-Y esophagojejunostomy and 15 patients(Group B)received totally laparoscopic total gastrectomy plus Roux-en-Y esophagojejunostomy in the Sir Run Run Shaw hospital.Clinical data of these patients,including operative indexes,post-operative indexes and fellow-up data,were analyzed respectively.Results A total of 30 patients were enrolled in this study(16 corpus carcinoma and 14 esophagogastric junction carcinoma).All the indexes and data in Group A were superior to Group B:the total operative time(group A:group B=255,3±30.2 min:262.7±30.2 min,t=-3.493,p=0.001<0.05),anastomosis time(group A:group B=25.6±2.7min:29.4±4.8min,t=-14.135,p<0.001),the blood loss during operation(group A:group B=80.4±48.8ml:102.4±84.9ml,t=-4.437,p<0.001),the first time to flatus(Group A:Group B=2.9±0.6d:4.0±0.8d,t=-21.798,p<0.001),the first fluid intake time(Group A:Group B=3.3±0.6d:5.8±0.9d,t=-48.554,p<0.001),postoperative hospital stay(group A:group B=8.5±1.4d:11.8±2.9d,t=-20.699,p<0.001).All the operations were performed successfully,and no one was transferred to open surgery.All the patients were encouraged to off-bed activity at first day after surgery.Pulmonary infection occurred in one patient in Group A and anastomotic stenosis occurred in two patients in Group B postoperatively.They were all recovered after treatment.No death and severe complication was found.Liver metastasis occurred in two patients and one patient was found recurrence in anastomotic site.Three Roux-en-Y stasis syndrome was found.No death and severe complication was found.Conclusions Uncut Roux-en-Y esophagojejunostomy in TLTG is safe and flexible. |
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