Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy

Study Overview
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Brief Summary
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Laparoscopic gastrectomy became a good option for early gastric cancer. Surgical trend is gradually changed to totally laparoscopic gastrectomy from laparoscopy-assisted gastrectomy requiring mini-laparotomy. Various types of intracorporeal anastomosis have been introduced for esophagojejunostomy during total gastrectomy. We invented a novel anastomosis method using linear stapler for total gastrectomy. Three procedures (Jejunal resection, esophageal resection and closure of common entry hole after anastomosis) was performed with only one stapler. Therefore, the novel method is simple and fast. Also, this new technique is better economically than previously introduced anastomosis using linear stapler because lesser number of stapler is required. We want to demonstrate the feasibility of novel intracorporeal anastomosis method during laparoscopic total gastrectomy.

Official Title
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Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy: π-shape Esophagojejunostomy, Three-in-one Technique

Conditions
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Gastric Cancer

Intervention / Treatment
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* Procedure: Intracorporeal esophagojejunostomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically confirmed adenocarcinoma in stomach Males or Females, aged≥20 years and ≤80 years Without serosa invasion, extraperigastric lymph node metastasis and other organ metastasis stage in preoperative evaluation, (cT1-3N0-1M0) Beyond the indication of ESD Tumor location in high body of stomach or requiring total gastrectomy Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1 at study entry American Society of Anesthesiolosists (ASA) score of 1 to 3 The patient has given their written informed consent to participate in the study Exclusion Criteria: Simultaneous malignancy in other organ Experience of previous laparotomy Experience of gastric resection including wedge resection Vulnerable subject

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intracorporeal esophagojejunostomy<br>Patient group with intracorporeal esophagojejunostomy with linear stapler | Procedure: Intracorporeal esophagojejunostomy<br>* Under laparoscopic view, esophagojejunostomy was pereformed with 60mm linear stapler on right side of distal esophagus like as functional end-to-end fashion before esophageal and jejunal resection. Then, three procedures of esophageal resection, common entry hole closure and jejunal resection was performed with a single use of 60mm stapler. Also, jejunojejunostomy was also performed via already made staple entry hole.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anastomosis related complication rate | Anastomotic leakage, intraluminal bleeding, or stenosis were considered as anastomosis related complication | During 30 days after operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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total gastrectomy, intracorporeal, totally laparoscopic, esophagojejunostomy, anastomosis