Esophagojejunostomy Reconstruction Using a Robot-Sewing Technique During Totally Robotic Total Gastrectomy for Gastric Cancer

摘要

Background/Aims: The aim of this study was to report on the feasibility of esophagojejunostomy reconstruction using a robot-sewing technique during a completely robotic total gastrectomy for gastric cancer. Methodology: Between May 2011 and July 2012, 65 patients in whom gastric adenocarcinoma was diagnosed underwent a completely robotic total gastrectomy, including a robot-sewing esophagojejunal anastomosis. We demonstrated the surgical techniques with analysis of clinicopathologic data and short-term surgical outcomes. Results: All robotic surgeries were successfully performed without conversion. Among the 65 patients, 46 were men and 19 were women. The mean age (+/- SD) was 57.8 +/- 6.5 y. The mean total operative time (+/- SD), EJ anastomosis time (+/- SD), and blood loss (+/- SD) were 245 53 min, 45 26 min, and 75 50 ml, respectively. The mean ( SD) post-operative hospital stay was 5.4 +/- 2.5 d. One patient was readmitted for an intestinal obstruction and underwent re-operation 14 d post-operatively; he recovered uneventfully and was discharged 10 d post-operatively. During the follow-up, no patients developed an esophgojejunostomy stricture. Conclusions: A robot-sewing anastomosis for esophagojejunostomy reconstruction during robotic total gastrectomy for gastric cancer is feasible. Indeed, a robot-sewing anastomosis for esophagojejunostomy reconstruction may become a standard surgical technique during completely robotic total gastrectomy for gastric cancer.