Short-term outcomes of intracorporeal esophagojejunostomy using the transorally inserted anvil versus extracorporeal circular anastomosis during laparoscopic total gastrectomy for gastric cancer: a propensity score matching analysis

Abstract Background To assess the short-term outcomes of intracorporeal Roux-en-Y esophagojejunostomy using the transorally inserted anvil (OrVil) compared with extracorporeal circular Roux-en-Y anastomosis during laparoscopic total gastrectomy (LTG) for gastric cancer. Methods From January 2011–Apr...

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Bibliographic Details
Published in:The Journal of surgical research 2016-02, Vol.200 (2), p.435-443
Main Authors: Lu, Xin, MD, Hu, Yanfeng, MD, Liu, Hao, MD, PhD, Mou, Tingyu, MD, Deng, Zhenwei, MD, Wang, Da, MD, Yu, Jiang, MD, Li, Guoxin, MD, PhD
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomosis, Surgical - instrumentation
Anastomosis, Surgical - methods
Esophagojejunostomy
Esophagus - surgery
Female
Follow-Up Studies
Gastrectomy - methods
Gastric cancer
Humans
Jejunum - surgery
Laparoscopic total gastrectomy
Laparoscopy - methods
Male
Middle Aged
Operative Time
OrVil
Postoperative Complications - epidemiology
Propensity Score
Propensity score matching
Retrospective Studies
Stomach Neoplasms - surgery
Surgery
Treatment Outcome
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Summary:Abstract Background To assess the short-term outcomes of intracorporeal Roux-en-Y esophagojejunostomy using the transorally inserted anvil (OrVil) compared with extracorporeal circular Roux-en-Y anastomosis during laparoscopic total gastrectomy (LTG) for gastric cancer. Methods From January 2011–April 2014, a total of 165 consecutive patients with gastric cancer underwent either intracorporeal Roux-en-Y esophagojejunostomy ( n  = 25) using the Orvil or extracorporeal circular anastomosis ( n  = 140) during LTG. After generating propensity scores with six covariates, including gender, age, body mass index (BMI), Eastern Cooperative Oncology Group performance status, tumor location, and tumor size, 25 patients undergoing the OrVil method (intracorporeal group) were one-to-one matched with 25 patients undergoing the extracorporeal method (extracorporeal group). The short-term outcomes were compared between the two groups. Results Both groups were balanced regarding baseline variables. The total operative time was not significantly different between the two groups (216.5 ± 24.9 min versus 224.0 ± 30.5 min, P  = 0.344), whereas either the duration of anvil insertion (9.9 ± 2.4 min versus 12.9 ± 2.0 min, P  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2015.08.013