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ヤマグチ シゲキ
YAMAGUCHI SHIGEKI
山口 茂樹 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Linear stapler anastomosis for esophagogastrostomy in laparoscopic proximal gastrectomy reduce reflux esophagitis. |
| 掲載誌名 | 正式名：Langenbeck's archives of surgery 略 称：Langenbecks Arch Surg ISSNコード：14352451/14352443 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 406(8),pp.2709-2716 |
| 著者・共著者 | Sugita Hirofumi, Sakuramoto Shinichi, Oya Shuichiro, Fujiwara Naoto, Miyawaki Yutaka, Satoh Hiroshi, Okamoto Kojun, Yamaguchi Shigeki, Koyama Isamu |
| 発行年月 | 2021/12 |
| 概要 | PURPOSE:There are various reconstruction methods for Laparoscopic proximal gastrectomy (LPG), such as esophagogastrostomy (EG), double-tract reconstruction, and jejunal interposition. We have performed EG using a circular stapler (OrVil) from 2013 and using a linear stapler from 2017. The aim of this retrospective study was to clarify which stapler is better for EG for LPG.METHODS:The data of 84 patients who underwent EG for LPG between January 2013 and September 2019 were analyzed. EG with fundoplication was done using a circular stapler (OrVil) in 45 patients (CS group) and a linear stapler in 39 patients (LS group). The patients' medical records were reviewed. Clinical symptoms were obtained by interview at each outpatient consultation. All patients underwent postoperative 1-year follow-up endoscopy. To minimize bias between the two groups, propensity scores were calculated using a logistic regression model. After propensity-score matching, 60 patients (30 in the CS group and 30 in the LS group) were studied.RESULTS:Patient characteristics, operative outcomes were similar in two groups. Anastomotic leakage occurred in one patient (3.3%) in both groups. Anastomotic stenosis occurred in five patients (16.7%) in the CS group and two patients (6.7%) in the LS group. The rate of patients with severe reflux esophagitis (grade C or D) was significantly lower in the LS group (3.4%) than in the CS group (26.7%) (p = 0.026).CONCLUSIONS:EG with a linear stapler could reduce the risk of severe reflux esophagitis, and it could be a safe and feasible anastomosis for patients after LPG. |
| DOI | 10.1007/s00423-021-02250-5 |
| PMID | 34155545 |