T-shaped functional end-to-end anastomosis as an alternative method for esophagojejunostomy after totally laparoscopic total gastrectomy for gastric cancer.
| Title: | T-shaped functional end-to-end anastomosis as an alternative method for esophagojejunostomy after totally laparoscopic total gastrectomy for gastric cancer. |
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| Authors: | Long VD; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Department of General Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Dat TQ; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Quang Thong D; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Thuy Nguyen D; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Minh Vu T; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Viet Hai N; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Hoang Bac N; Department of Gastro-Intestinal Surgery, University of Medical Center at Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.; Department of General Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. |
| Source: | Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy [Minim Invasive Ther Allied Technol] 2025 Dec; Vol. 34 (6), pp. 456-467. Date of Electronic Publication: 2025 Sep 08. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 9612996 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2931 (Electronic) Linking ISSN: 13645706 NLM ISO Abbreviation: Minim Invasive Ther Allied Technol Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : Informa Healthcare; Original Publication: Oxford : Blackwell Science, c1996- |
| MeSH Terms: | Stomach Neoplasms*/surgery ; Gastrectomy*/methods ; Laparoscopy*/methods ; Anastomosis, Surgical*/methods ; Jejunostomy*/methods; Postoperative Complications/epidemiology ; Esophagus/surgery ; Jejunum/surgery ; Humans ; Male ; Female ; Middle Aged ; Aged ; Operative Time ; Retrospective Studies ; Treatment Outcome ; Length of Stay ; Cohort Studies ; Propensity Score |
| Abstract: | Background: Functional end-to-end anastomosis (FEEA) and the overlap methods for reconstruction after totally laparoscopic total gastrectomy (TLTG) pose technical challenges. We developed a modified T-shaped FEEA to facilitate the procedure. This study aimed to evaluate the short- and long-term outcomes of the modified T-shaped FEEA compared to the overlap method following TLTG for gastric cancer (GC).; Method: This cohort study enrolled 114 patients with middle- or upper-third GC who underwent TLTG with linear stapler for reconstruction between August 2015 and October 2020. Outcomes analyzed included operative characteristics, postoperative complications, one-year nutritional status, and long-term survival. Propensity score-matched (PSM) was applied to adjust for baseline differences between groups.; Results: After PSM, 27 patients were included in each group. No significant differences were found between the two groups in terms of early surgical outcomes, including operating time, time of first flatus, overall morbidities and mortality, and postoperative hospital stays. However, the modified T-shaped FEEA group had a significantly shorter anastomosis time (37.2 vs. 50.7 min, p = 0.005). Changes in body weight, hemoglobin, and albumin levels one-year postoperatively were comparable. Similarly, there was no significant difference in five-year overall survival and disease-free survival between the two groups (60% vs. 53% and 49% vs. 40%, respectively).; Conclusions: The modified T-shaped FEEA method offers a viable alternative to the overlap method for reconstruction after TLTG for GC, with shorter anastomosis time and comparable surgical and long-term outcomes. |
| Contributed Indexing: | Keywords: Laparoscopic total gastrectomy; esophagojejunostomy; functional End-To-End anastomosis; gastric cancer; reconstruction |
| Entry Date(s): | Date Created: 20250908 Date Completed: 20251201 Latest Revision: 20251201 |
| Update Code: | 20260130 |
| DOI: | 10.1080/13645706.2025.2556883 |
| PMID: | 40921422 |
| Database: | MEDLINE |
Journal Article