Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic...

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Laparoscopic Procedures

Background:

• The hemidouble stapler technique (HDST) for laparoscopic intracorporeal esophagojejunostomy carries inherent risks to anastomotic safety.
• Laparoscopic total gastrectomy (LTG) necessitates secure and efficient esophagojejunostomy construction.

Purpose of the Study:

• To introduce and evaluate a novel ghosting double stapling technique (GDST) for esophagojejunostomy in LTG.
• To compare the safety and efficacy of GDST against the established HDST.

Main Methods:

• Retrospective review of patients undergoing LTG for gastric cancer between October 2016 and May 2022.
• Comparison of two groups: GDST (n=14) and HDST (n=16), analyzing demographics, perioperative, and postoperative outcomes.
• Exclusion of two HDST patients due to unassessed anastomoses via endoscopy.

Main Results:

• GDST significantly reduced mean total operative time (224.3 ± 36.1 min) compared to HDST (292.6 ± 43.7 min; p < 0.001).
• Esophagojejunostomy construction time was also shorter with GDST (26.8 ± 6.4 min) versus HDST (38.6 ± 4.3 min; p < 0.001).
• One case of anastomotic stenosis occurred in the HDST group; no anastomotic leakage was observed in either group, with no significant difference in overall morbidity (p > 0.05).

Conclusions:

• Both the ghosting double stapling technique (GDST) and the hemidouble stapler technique (HDST) are safe for esophagojejunostomy in laparoscopic total gastrectomy.
• GDST demonstrates potential for reduced operative time in LTG procedures.