Objective To explore method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer (GC). Methods The clinical data of 30 patients with distal GC underwent the total laparoscopic radical gastrectomy from October 2017 to March 2018 in the Departmeng of Tumor Surgery, Lanzhou University Second Hospital were retrospectively analyzed, the total laparoscopic radical distal gastrectomy were performed in all the patients and the jejunum nutrition tube were implanted during the operation. Results Thirty patients with distal GC were successfully treated with the total laparoscopic radical gastrectomy and the jejunum nutrition tubes were implanted into under the total laparoscopy through the intraoperative guidance by the gastric tube, firstly fastening the nutrition tube to the gastric tube in vitro, and then separating them in vivo, finally the nutrition tube was smoothly implanted into the jejunum under the direct vision. The implantation time was 10 to 15 min with an average of 13.5 min. The jejunal nutrition tube retention time was 5 to 7 d with an average of 6 d. There were no complications such as the bleeding, anastomotic leakage, anastomotic obstruction, stenosis, intestinal leakage, intestinal obstruction, and other complications after the operation in the 30 patients. Conclusions Method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal GC is easy to be performed. Intraoperative and postoperative complications are few. It provides a favorable guarantee for improving postoperative nutritional status of patient with distal GC.
ObjectiveTo investigate the application value of the bidirectional sutures method in total laparoscopic radical total gastrectomy with esophagojejunal overlap anastomosis. MethodsA retrospective descriptive study was conducted. A retrospective analysis was performed on 128 patients with gastric cancer who underwent totally laparoscopic total gastrectomy (TLTG) in the Department of Gastrointestinal Surgery of Chengdu Third People's Hospital from December 2020 to December 2023. Patients in the observation group underwent bidirectional suture overlap esophagojejunostomy, while patients in the control group received conventional overlap side-to-side esophagojejunostomy. The two groups were then compared based on clinical outcome measures. ResultsA total of 128 patients were included, including 80 in the observation group and 48 in the control group. The anastomosis time ［(25.75±5.78) min vs (29.43±2.73) min, P＜0.001］, operative time ［(244.81±39.16) min vs (257.18±44.36) min, P=0.037］, time to postoperative flatus ［(2.30±0.80) d vs (2.85±1.33) d, P=0.004］, and postoperative hospital stay ［(7.15±2.10) d vs (9.00±2.66) d, P＜0.001］of the observation group shorter than those in the control group. In the observation group, anastomotic leakage occurred in one patient (Clavien-Dindo grade Ⅱ), who improved with conservative treatment and was discharged. All patients were successfully followed up at 1, 3, 6, and 12 months after surgery, and the median follow-up time was 12 months. During follow-up, four deaths occurred (two in the observation group and two in the control group), all non-cancer-related. No other complications, recurrences, or metastases were observed. ConclusionsThe bidirectional suture overlap esophagojejunostomy is a safe and feasible technique for performing a totally laparoscopic radical total gastrectomy, providing favorable short-term effects.