Technique of Roux-en-Y reconstruction using overlap method after laparoscopic total gastrectomy for XXXX : 100 consecutively successful cases.

@entity1 @entity834 @entity548 @entity190 @entity254 @entity260 @entity3472 @entity850 @entity356
BACKGROUND: We have established a standard procedure for Roux-en-Y (RY) reconstruction in laparoscopic total gastrectomy (LTG) using esophagojejunostomy by the overlap method (OL). We report on our RY reconstruction technique and special approaches, and evaluate the usefulness of our reconstruction method based on the surgical results of 100 @entity1 we have experienced to date. METHODS: We performed LTG in 100 @entity1 with @entity356 . After total gastrectomy using five ports, the resected stomach was extracted through a small laparotomy. Through that, we performed sacrifice of the jejunum, Y limb @entity254 , creation of the lifted jejunum. As the OL, a side-to-side @entity254 of the lifted jejunum to the esophageal stump was laparoscopically performed using a linear stapler in an isoperistaltic direction, and the entry hole was closed with full-thickness suturing. The lifted jejunum was fixed with suture to the duodenal stump at a location where the esophagojejunostomy site was made linear, and the duodenal stump was buried. The mesenteric gap was laparoscopically closed with suture. RESULTS: The median operative time in 100 @entity1 undergoing LTG was 385  min, the median @entity190 was 65  mL, and the median time required for the OL was 32  min. The mean hospitalization period was 10  days, and @entity260 included @entity548 requiring reoperation in one @entity1 ; other complications such as @entity3472 in five @entity1 (5  %) were treated conservatively. No complication associated with @entity254 occurred. CONCLUSION: In RY reconstruction using the OL, there were no complications associated with the @entity254 site in 100 consecutive @entity1 , such as @entity834 or @entity850 , indicating that it is a very useful and safe reconstruction method.
