Esophagojejunostomy using a circular stapler vs. a linear stapler for gastric cardia cancer patients: impact of upper margin length and tumor size on the survival rate.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1385754

Maniragaba Dieudonne, Renguang Lv, Wenjie Xie, Qi Liu, Jianwu Jiang, Yang Fu

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引用次数: 0

Abstract

Background: The incidence of gastric cancer is concomitantly rising with gastric cardia cancer worldwide. While the improvement of gastric cancer surgical techniques is glowing, this study assesses the impact of the upper margin length and tumor size on the survival rate for gastric cardia cancer patients who underwent total laparoscopic total gastrectomy(TLTG) or laparoscopic assisted total gastrectomy(LATG).

Materials and methods: A total of 63 patients with gastric cardia cancer who underwent laparoscopic total gastrectomy were retro-prospectively collected from January 2021 to May 2023. While assessing the impact of upper margin length and tumor size on the survival rate, esophagojejunostomy using a linear stapler has been compared to a circular stapler.

Results: The sixty-three patients met inclusion criteria; 32 (51%) underwent LATG and 31 (49%) underwent TLTG. Their mean age was 65 years (range, 45-77). The blood loss means in LATG and TLTG was 74.69 and 50.16 ml, respectively (p = 0.005), and surgery duration was higher in LATG than LATG with respective means of 247 min and 222.42 min. (p = 0.006). However, the tumor size means (p = 0.5), and upper margin length means (p = 0.052) were not significantly different in the LATG and TLTG groups, respectively. The number of resected and assessed lymph node was adequate in the LATG and TLTG groups. The current study still does not find an independent related risk from the upper margin length and tumor size to the survival rate according to the multiple regression analysis (p = 0.080).

Conclusion: The upper margin length and tumor size do not have a relationship with the survival rate of the compared esophagojejunostomy (EJS) methods. The EJS using a linear stapler requires a shorter surgery duration and less blood loss than EJS using a circular stapler.

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使用环形订书机与线形订书机为胃贲门癌患者进行食管空肠吻合术：上缘长度和肿瘤大小对生存率的影响。

背景：在全球范围内，胃癌和胃贲门癌的发病率呈同步上升趋势。在胃癌手术技术不断改进的同时，本研究评估了上缘长度和肿瘤大小对接受全腹腔镜全胃切除术（TLTG）或腹腔镜辅助全胃切除术（LATG）的胃贲门癌患者生存率的影响：回顾性收集2021年1月至2023年5月期间接受腹腔镜全胃切除术的63例胃贲门癌患者。在评估上缘长度和肿瘤大小对生存率的影响时，将使用线性订书机和圆形订书机进行食管空肠吻合术进行了比较：63名患者符合纳入标准，其中32人（51%）接受了LATG，31人（49%）接受了TLTG。他们的平均年龄为 65 岁（45-77 岁不等）。LATG 和 TLTG 的平均失血量分别为 74.69 毫升和 50.16 毫升（P = 0.005），LATG 的手术时间比 LATG 长，分别为 247 分钟和 222.42 分钟（P = 0.006）。不过，LATG 组和 TLTG 组的肿瘤大小平均值（p = 0.5）和上缘长度平均值（p = 0.052）分别没有显著差异。LATG 组和 TLTG 组切除和评估的淋巴结数量充足。根据多元回归分析，本研究仍未发现上缘长度和肿瘤大小与生存率的独立相关风险（P = 0.080）：结论：上缘长度和肿瘤大小与食管空肠吻合术（EJS）的生存率没有关系。与使用圆形订书机的食管空肠吻合术相比，使用线性订书机的食管空肠吻合术手术时间更短，失血量更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.