Annals of Surgery

Skip Navigation LinksHome > January 2014 - Volume 259 - Issue 1 > Advantage of Completely Laparoscopic Gastrectomy With Linear...
Annals of Surgery:
doi: 10.1097/SLA.0b013e31828dfa5d
Original Articles

Advantage of Completely Laparoscopic Gastrectomy With Linear Stapled Reconstruction: A Long-term Follow-up Study

Okabe, Hiroshi MD, PhD; Obama, Kazutaka MD, PhD; Tsunoda, Shigeru MD, PhD; Tanaka, Eiji MD, PhD; Sakai, Yoshiharu MD, PhD

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Abstract

Background: Completely laparoscopic gastrectomy with intracorporeal anastomosis was introduced to achieve safer anastomosis and smaller scars. Although several reports have shown the feasibility of linear-stapled anastomosis, there are no studies of a large number of patients assessing the long-term complications and functional outcomes.

Methods: This retrospective study included 345 patients who had intended to undergo completely laparoscopic distal or total gastrectomy with linear-stapled anastomosis between September 2005 and January 2012. This study evaluated both the short- and long-term complications, as well as the endoscopic findings, changes in body weight and serum albumin.

Results: Completely laparoscopic gastrectomy was successfully achieved in 342 patients (99.1%). Short-term complications occurred in 59 patients (17.3%). Reconstruction-related complications were observed in 19 patients (5.6%). Three patients with anastomotic leakage required reoperation. No patient experienced anastomotic stenosis over a mean follow-up period of 29.6 months. Two patients underwent an emergency operation for an internal hernia after total gastrectomy. Adhesive intestinal obstruction was observed in 5 patients (1.5%), but all were resolved without surgical intervention. Body weight loss at 2 years after distal and total gastrectomy was 7.2% and 13.9%, which were similar to previous reports of open surgery.

Conclusions: Completely laparoscopic gastrectomy with linear-stapled anastomosis is a feasible choice for gastric cancer patients with some potential long-term advantages such as less anastomotic stenosis and fewer adhesive intestinal obstructions.

© 2014 by Lippincott Williams & Wilkins.

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