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Review
, 12 (1), 21-36

Digestive Tract Reconstruction Options After Laparoscopic Gastrectomy for Gastric Cancer

Affiliations
Review

Digestive Tract Reconstruction Options After Laparoscopic Gastrectomy for Gastric Cancer

Jian Shen et al. World J Gastrointest Oncol.

Abstract

In addition to the popularity of laparoscopic gastrectomy (LG), many reconstructive procedures after LG have been reported. Surgical resection and lymphatic dissection determine long-term survival; however, the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer (GC). Presently, no consensus exists regarding the optimal reconstructive procedure. In this review, the current state of digestive tract reconstruction after LG is reviewed. According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction, we divide these reconstruction procedures into three categories consistent with the resection procedures. We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes (length of surgery and blood loss) and postoperative complications (anastomotic leakage and stricture) to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

Keywords: Digestive tract reconstruction; Gastric cancer; Laparoscopic gastrectomy; Quality of life.

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Schematic pictures of digestive tract reconstruction after laparoscopic distal gastrectomy. A: Billroth-I reconstruction; B: Billroth-II reconstruction with Braun anastomosis; C: Roux-en-Y reconstruction; D: Uncut Roux-en-Y reconstruction.
Figure 2
Figure 2
Schematic picture of double tract reconstruction after laparoscopic proximal gastrectomy.
Figure 3
Figure 3
Esophagojejunostomy via circular stapler methods. A: OrVil™; B: Semicircumferential esophagotomy performed at the anterior esophageal wall (reverse puncture method); C: The center rod of the anvil penetrates the esophageal wall by drawing the suture; D: Esophagojejunostomy accomplished with a circular stapler under laparoscopic monitoring.
Figure 4
Figure 4
Esophagojejunostomy via linear stapler methods. A: Functional end-to-end anastomosis; B: Overlap; C: π-type anastomosis.

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References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68:7–30. - PubMed
    1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115–132. - PubMed
    1. Agolli L, Nicosia L. Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer: Is there still a role for radiation therapy? World J Gastrointest Oncol. 2018;10:271–281. - PMC - PubMed
    1. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4) Gastric Cancer. 2017;20:1–19. - PMC - PubMed
    1. Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, Kim JM, Kim YI, Ryu KW, Kong SH, Kim HI, Jung HY, Kim YS, Zang DY, Cho JY, Park JO, Lim DH, Jung ES, Ahn HS, Kim HJ. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer. 2014;14:87–104. - PMC - PubMed
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