{"title":"腹腔内环钉胃十二指肠吻合术在腹腔镜远端胃全切除术中的应用。","authors":"Ying Yang, Linsen Zhou, Jing Zhuang, Yizhou Sun, Yuemei Ding, Haohai Jiang","doi":"10.3389/fsurg.2025.1635611","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>While laparoscopic distal gastrectomy (LDG) has gained acceptance for early gastric cancer, challenges persist in intracorporeal circular-stapled gastroduodenostomy during totally laparoscopic distal gastrectomy (TLDG). This study introduces a novel technique using a laparoscopic purse-string suture clamp (Lap-PSC) and multifunctional sealing cap (MSC) to simplify Billroth I circular-stapled anastomosis.</p><p><strong>Methods: </strong>A single-center retrospective analysis was conducted on 47 gastric cancer patients undergoing TLDG with Lap-PSC and MSC between September 2022 and June 2024. Surgical procedures involved D2 lymph node dissection, a 5 cm upper abdominal incision for specimen extraction, and intracorporeal circular-stapled anastomosis using Lap-PSC for duodenal purse-string suturing and MSC for pneumoperitoneum maintenance. Postoperative outcomes, complications, and anastomotic integrity were evaluated.</p><p><strong>Results: </strong>All 47 patients underwent successful TLDG with negative resection margins. Mean operative time was 148.3 ± 41.4 min. One patient (2.1%) experienced postoperative gastroparesis, and one patient (2.1%) experienced postoperative pneumonia. No anastomotic leaks, strictures, or perioperative deaths occurred. Median follow-up was 21.4 months (range: 13-34), with no recurrence or anastomosis-related complications.</p><p><strong>Conclusion: </strong>TLDG with Circular-Stapled Gastroduodenostomy for Billroth I anastomosis demonstrates technical feasibility and safety, combining the precision of open surgery with laparoscopic minimally invasive benefits. The technique simplifies intracorporeal circular-stapled anastomosis, avoids excessive tension, and may reduce ischemic risks associated with linear stapler methods.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1635611"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491168/pdf/","citationCount":"0","resultStr":"{\"title\":\"Intracorporeal circular-stapled gastroduodenostomy for billroth I reconstruction in total laparoscopic distal gastrectomy.\",\"authors\":\"Ying Yang, Linsen Zhou, Jing Zhuang, Yizhou Sun, Yuemei Ding, Haohai Jiang\",\"doi\":\"10.3389/fsurg.2025.1635611\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>While laparoscopic distal gastrectomy (LDG) has gained acceptance for early gastric cancer, challenges persist in intracorporeal circular-stapled gastroduodenostomy during totally laparoscopic distal gastrectomy (TLDG). This study introduces a novel technique using a laparoscopic purse-string suture clamp (Lap-PSC) and multifunctional sealing cap (MSC) to simplify Billroth I circular-stapled anastomosis.</p><p><strong>Methods: </strong>A single-center retrospective analysis was conducted on 47 gastric cancer patients undergoing TLDG with Lap-PSC and MSC between September 2022 and June 2024. Surgical procedures involved D2 lymph node dissection, a 5 cm upper abdominal incision for specimen extraction, and intracorporeal circular-stapled anastomosis using Lap-PSC for duodenal purse-string suturing and MSC for pneumoperitoneum maintenance. Postoperative outcomes, complications, and anastomotic integrity were evaluated.</p><p><strong>Results: </strong>All 47 patients underwent successful TLDG with negative resection margins. Mean operative time was 148.3 ± 41.4 min. One patient (2.1%) experienced postoperative gastroparesis, and one patient (2.1%) experienced postoperative pneumonia. No anastomotic leaks, strictures, or perioperative deaths occurred. Median follow-up was 21.4 months (range: 13-34), with no recurrence or anastomosis-related complications.</p><p><strong>Conclusion: </strong>TLDG with Circular-Stapled Gastroduodenostomy for Billroth I anastomosis demonstrates technical feasibility and safety, combining the precision of open surgery with laparoscopic minimally invasive benefits. The technique simplifies intracorporeal circular-stapled anastomosis, avoids excessive tension, and may reduce ischemic risks associated with linear stapler methods.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"12 \",\"pages\":\"1635611\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491168/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2025.1635611\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1635611","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Intracorporeal circular-stapled gastroduodenostomy for billroth I reconstruction in total laparoscopic distal gastrectomy.
Objectives: While laparoscopic distal gastrectomy (LDG) has gained acceptance for early gastric cancer, challenges persist in intracorporeal circular-stapled gastroduodenostomy during totally laparoscopic distal gastrectomy (TLDG). This study introduces a novel technique using a laparoscopic purse-string suture clamp (Lap-PSC) and multifunctional sealing cap (MSC) to simplify Billroth I circular-stapled anastomosis.
Methods: A single-center retrospective analysis was conducted on 47 gastric cancer patients undergoing TLDG with Lap-PSC and MSC between September 2022 and June 2024. Surgical procedures involved D2 lymph node dissection, a 5 cm upper abdominal incision for specimen extraction, and intracorporeal circular-stapled anastomosis using Lap-PSC for duodenal purse-string suturing and MSC for pneumoperitoneum maintenance. Postoperative outcomes, complications, and anastomotic integrity were evaluated.
Results: All 47 patients underwent successful TLDG with negative resection margins. Mean operative time was 148.3 ± 41.4 min. One patient (2.1%) experienced postoperative gastroparesis, and one patient (2.1%) experienced postoperative pneumonia. No anastomotic leaks, strictures, or perioperative deaths occurred. Median follow-up was 21.4 months (range: 13-34), with no recurrence or anastomosis-related complications.
Conclusion: TLDG with Circular-Stapled Gastroduodenostomy for Billroth I anastomosis demonstrates technical feasibility and safety, combining the precision of open surgery with laparoscopic minimally invasive benefits. The technique simplifies intracorporeal circular-stapled anastomosis, avoids excessive tension, and may reduce ischemic risks associated with linear stapler methods.
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.
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