Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2017; 23(45): 8035-8043
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8035
Two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy
Yu Liu, Ji-Jia Li, Peng Zu, Hong-Xu Liu, Zhan-Wu Yu, Yi Ren
Yu Liu, Ji-Jia Li, Peng Zu, Hong-Xu Liu, Zhan-Wu Yu, Yi Ren, Department of Thoracic Surgery, Cancer Hospital of China Medical University/Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Author contributions: Liu Y, Li JJ, Liu HX, Yu ZW and Ren Y designed research; Liu Y and Ren Y performed research; Zu P provided the schematic diagram; Liu Y, Li JJ, Liu HX, Yu ZW and Ren Y analyzed data; Liu Y and Ren Y wrote the paper.
Institutional review board statement: This study has been approved by the Ethics Committee of Cancer Hospital of China Medical University, Shenyang, China.
Informed consent statement: All patients involved signed the informed consent documents before operation.
Conflict-of-interest statement: There are no conflicts of interest in relation to this manuscript.
Data sharing statement: There are no additional data available in relation to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yi Ren, MD, Professor, Department of Thoracic Surgery, Cancer Hospital of China Medical University/Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China. renyi@cancerhosp-ln-cmu.com
Telephone: +86-24-31916273 Fax: +86-24-24315679
Received: May 5, 2017
Peer-review started: June 1, 2017
First decision: June 22, 2017
Revised: August 15, 2017
Accepted: September 5, 2017
Article in press: September 5, 2017
Published online: December 7, 2017
Processing time: 186 Days and 22.1 Hours
Abstract
AIM

To introduce a two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy and assess its clinical application.

METHODS

One hundred and twenty-two patients with middle or lower esophageal cancer who underwent laparoscopic-thoracoscopic Ivor-Lewis esophagectomy at Liaoning Cancer Hospital and Institute from March 2014 to March 2016 were included in this study, and divided into two groups based on the procedure used for creating a gastric tube. One group used a two-step method for creating a gastric tube, and the other group used the conventional method. The two groups were compared regarding the operating time, surgical complications, and number of stapler cartridges used.

RESULTS

The mean operating time was significantly shorter in the two-step method group than in the conventional method group [238 (179-293) min vs 272 (189-347) min, P < 0.01]. No postoperative death occurred in either group. There was no significant difference in the rate of complications [14 (21.9%) vs 13 (22.4%), P = 0.55] or mean number of stapler cartridges used [5 (4-6) vs 5.2 (5-6), P = 0.007] between the two groups.

CONCLUSION

The two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy has the advantages of simple operation, minimal damage to the tubular stomach, and reduced use of stapler cartridges.

Keywords: Minimally invasive srugery; Gastric tube; Ivor-Lewis esophagectomy

Core tip: The two-step method accomplishes totally laparoscopic-thoracoscopic Ivor-Lewis esophagectomy, by avoiding an additional abdominal incision and conducting operations via the operating port to simplify the complicated operation steps, thus greatly reducing the difficulty in creating the gastric tube after anastomosis, and shortening the operating time.