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Potential of Overlap Guiding Tube-Assisted Method of Esophagojejunostomy for Gastric/Gastroesophageal Junction Cancer
A study found that the overlap guiding tube (OGT)-assisted method of overlap esophagojejunostomy (EJS) reduced surgical difficulty of the procedure and exhibited good safety.
This retrospective analysis included data from 155 patients with gastric/gastroesophageal junction cancer who underwent laparoscopic total gastrectomy. Patients were classified by method of surgery: conventional (n = 83) or OGT-assisted (n = 72). The outcomes observed were anastomotic efficiency and surgical outcomes, compared between the 2 groups.
The duration of surgery for the OGT group was significantly shorter than in the conventional group. The rate of successful insertion of anvil fork at the first attempt was also much higher in the OGT group than the conventional. In the conventional group, there was 1 instance each of esophageal pseudocanal development and conversion to thoracoscopic surgery while there were no such cases in the OGT group.
While not statistically significant differences, the incidence of postoperative complications and the severity of complications were milder in the OGT group. Within the conventional group, there were 4 cases of esophagojejunal anastomotic leakage and 1 case of anastomotic stenosis. In the OGT group, 2 patients developed esophagojejunal anastomotic leakage, with no instances of anastomotic stenosis or bleeding. There were no instances in either group of unplanned secondary surgery or perioperative deaths.
Study authors concluded this analysis “provides new perspectives for optimizing EJS.”
Source:
Chen X, Lin T, Zhao M, et al. Safety and efficacy of OGT-assisted overlap oesophagojejunostomy versus the traditional overlap method in laparoscopic total gastrectomy for gastric/gastroesophageal junction (G/GEJ) tumors. Ann Surg Oncol. Published online January 19, 2023. doi:10.1245/s10434-022-13031-9
