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首页> 外文期刊>Surgical Endoscopy >Comparison of surgical outcomes among different methods of esophagojejunostomy in laparoscopic total gastrectomy for clinical stage I proximal gastric cancer: results of a single-arm multicenter phase II clinical trial in Korea, KLASS 03
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Comparison of surgical outcomes among different methods of esophagojejunostomy in laparoscopic total gastrectomy for clinical stage I proximal gastric cancer: results of a single-arm multicenter phase II clinical trial in Korea, KLASS 03

机译：在腹腔镜临床阶段腹腔镜腹腔镜腹腔镜腹膜术中不同方法的比较I近端胃癌：韩国单臂多中心临床试验的结果，Klass 03

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Background Laparoscopic distal gastrectomy for early gastric cancer has been widely accepted, but laparoscopic total gastrectomy has still not gained popularity because of technical difficulty and unsolved safety issue. We conducted a single-arm multicenter phase II clinical trial to evaluate the safety and the feasibility of laparoscopic total gastrectomy for clinical stage I proximal gastric cancer in terms of postoperative morbidity and mortality in Korea. The secondary endpoint of this trial was comparison of surgical outcomes among the groups that received different methods of esophagojejunostomy (EJ). Methods The 160 patients of the full analysis set group were divided into three groups according to the method of EJ, the extracorporeal circular stapling group (EC;n = 45), the intracorporeal circular stapling group (IC;n = 64), and the intracorporeal linear stapling group (IL;n = 51). The clinicopathologic characteristics and the surgical outcomes were compared among these three groups. Results There were no significant differences in the early complication rates among the three groups (26.7% vs. 18.8% vs. 17.6%, EC vs. IC vs. IL;p = 0.516). The length of mini-laparotomy incision was significantly longer in the EC group than in the IC or IL group. The anastomosis time was significantly shorter in the EC group than in the IL group. The time to first flatus was significantly shorter in the IL group than in the EC group. The long-term complication rate was not significantly different among the three groups (4.4% vs. 12.7% vs. 7.8%; EC vs. IC vs. IL;p = 0.359), however, the long-term incidence of EJ stenosis in IC group (10.9%) was significantly higher than in EC (0%) and IL (2.0%) groups (p = 0.020). Conclusions The extracorporeal circular stapling and the intracorporeal linear stapling were safe and feasible in laparoscopic total gastrectomy, however, intracorporeal circular stapling increased EJ stenosis.
机译：背景腹腔镜下远端胃切除术治疗早期胃癌已被广泛接受，但由于技术困难和安全问题尚未解决，腹腔镜全胃切除术尚未普及。我们进行了一项单臂多中心II期临床试验，以评估韩国临床I期近端胃癌腹腔镜全胃切除术在术后发病率和死亡率方面的安全性和可行性。本试验的第二个终点是比较不同食管空肠吻合术（EJ）组的手术结果。方法根据EJ方法将160例全分析组患者分为三组：体外循环吻合器组（EC；n=45）、体内循环吻合器组（IC；n=64）和体内线性吻合器组（IL；n=51）。比较三组患者的临床病理特征和手术结果。结果三组早期并发症发生率无显著差异（26.7%对18.8%对17.6%，EC对IC对IL，p=0.516）。EC组的小切口长度明显长于IC或IL组。EC组的吻合时间明显短于IL组。IL组首次排气的时间明显短于EC组。三组之间的长期并发症发生率没有显著差异（4.4%对12.7%对7.8%；EC对IC对IL；p=0.359），然而，IC组EJ狭窄的长期发生率（10.9%）显著高于EC（0%）和IL（2.0%）组（p=0.020）。结论在腹腔镜全胃切除术中，体外环形吻合器和体内线性吻合器是安全可行的，但体内环形吻合器增加了EJ狭窄。

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