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Totally laparoscopic total gastrectomy for gastric cancer: Literature review and comparison of the procedure of esophagojejunostomy

机译:完全腹腔镜胃全胃切除术治疗胃癌:文献综述及食管空肠吻合术的比较

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Summary There has been a recent increase in the use of totally laparoscopic total gastrectomy (TLTG) for gastric cancer. However, there is no scientific evidence to determine which esophagojejunostomy (EJS) technique is the best. In addition, both short- and long-term oncological results of TLTG are inconsistent. We reviewed 25 articles about TLTG for gastric cancer in which at least 10 cases were included. We analyzed the short-term results, relationships between EJS techniques and complications, long-term oncological results, and comparative study results of TLTG. TLTG was performed in a total of 1170 patients. The mortality rate was 0.7%, and the short-term results were satisfactory. Regarding EJS techniques and complications, circular staplers (CSs) methods were significantly associated with leakage (4.7% vs. 1.1%, p ?
机译:总结最近,全腹腔镜全胃切除术(TLTG)用于胃癌的使用有所增加。但是,没有科学证据来确定哪种食管空肠吻合术(EJS)最好。此外,TLTG的短期和长期肿瘤学结果均不一致。我们审查了有关胃癌的TLTG的25篇文章,其中至少包括10例。我们分析了短期结果,EJS技术与并发症之间的关系,长期肿瘤学结果以及TLTG的比较研究结果。 TLTG共进行了1170例患者。死亡率为0.7%,短期结果令人满意。关于EJS技术和并发症,圆形缝合器(CSs)方法与EJS的渗漏(4.7%vs. 1.1%,p <0.001)和狭窄(8.3%vs. 1.8%,p <0.001)显着相关。与线性订书机方法相比早期胃癌且无转移至淋巴结的患者的长期肿瘤学预后是可以接受的。尽管与开放式全胃切除术和腹腔镜辅助全胃切除术相比,TLTG倾向于增加手术时间,但它可减少术中失血量,并有望缩短术后住院时间。发现TLTG比开放式全胃切除术和腹腔镜辅助全胃切除术更安全,更可行。从长期肿瘤学预后的角度来看,目前尚无证据鼓励晚期胃癌患者进行TLTG。尽管当前主要的EJS技术是CS和线性订书机方法,但在本文中,CS方法与EJS的渗漏和狭窄显着相关。

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