The Hepatic Left Lateral Segment Inverting Method Offering a Wider Operative Field of View During Laparoscopic Proximal Gastrectomy.
Gastrectomy
Intraoperative complications
Laparoscopy
Postoperative complications
Stomach neoplasms
Journal
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
20
02
2020
accepted:
13
05
2020
pubmed:
31
5
2020
medline:
15
4
2021
entrez:
31
5
2020
Statut:
ppublish
Résumé
In laparoscopic proximal gastrectomy, the hepatic left lateral segment often obstructs the operative field of view, especially around the esophageal hiatus. Therefore, a safe retraction method is needed. The present study aimed to determine the effectiveness of inverting the hepatic left lateral segment in laparoscopic proximal gastrectomy. This was a retrospective review of 81 consecutive patients who underwent laparoscopic proximal gastrectomy. Patients were divided into two groups, i.e., the Nathanson liver retractor group (n = 41) and hepatic left lateral segment inverting group (n = 40). The unedited video recordings of the procedures and the patients' medical records were reviewed and compared. The hepatic left lateral segment inverting method provided a more satisfactory view of the operative fields and a wider working space around the esophageal hiatus than the Nathanson liver retractor. No intraoperative hepatic congestion and significantly improved postoperative liver enzyme elevations were observed with hepatic left lateral segment inverting method compared with the Nathanson liver retractor method. In laparoscopic proximal gastrectomy, the hepatic left lateral segment inverting method appears to provide improvements in both the operative field of view and liver protection compared with the Nathanson liver retractor method.
Sections du résumé
BACKGROUND
In laparoscopic proximal gastrectomy, the hepatic left lateral segment often obstructs the operative field of view, especially around the esophageal hiatus. Therefore, a safe retraction method is needed. The present study aimed to determine the effectiveness of inverting the hepatic left lateral segment in laparoscopic proximal gastrectomy.
METHODS
This was a retrospective review of 81 consecutive patients who underwent laparoscopic proximal gastrectomy. Patients were divided into two groups, i.e., the Nathanson liver retractor group (n = 41) and hepatic left lateral segment inverting group (n = 40). The unedited video recordings of the procedures and the patients' medical records were reviewed and compared.
RESULTS
The hepatic left lateral segment inverting method provided a more satisfactory view of the operative fields and a wider working space around the esophageal hiatus than the Nathanson liver retractor. No intraoperative hepatic congestion and significantly improved postoperative liver enzyme elevations were observed with hepatic left lateral segment inverting method compared with the Nathanson liver retractor method.
CONCLUSIONS
In laparoscopic proximal gastrectomy, the hepatic left lateral segment inverting method appears to provide improvements in both the operative field of view and liver protection compared with the Nathanson liver retractor method.
Identifiants
pubmed: 32472268
doi: 10.1007/s11605-020-04655-x
pii: 10.1007/s11605-020-04655-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2395-2403Références
Yamashita H, Seto Y, Sano T, Makuuchi H, Ando N, Sasako M. Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma. Gastric Cancer 2017;20:69-83.
doi: 10.1007/s10120-016-0663-8
Kinjo Y, Okabe H, Obama K, Tsunoda S, Tanaka E, Sakai Y. Elevation of liver function tests after laparoscopic gastrectomy using a Nathanson liver retractor. World J Surg 2011;35:2730-2738.
doi: 10.1007/s00268-011-1301-6
Nakauchi M, Suda K, Susumu S, Kadoya S, Inaba K, Ishida Y, Uyama I. Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach: a single institutional retrospective cohort study. Surg Endosc 2016;30:5444-5452.
doi: 10.1007/s00464-016-4904-z
Japanese Gastric Cancer Association. Gastric Cancer Treatment Guidelines 2018. The 5th Edition. Tokyo: KANEHARA & CO., LTD., 2018.
Suda K, Man IM, Ishida Y, Kawamura Y, Satoh S, Uyama I. Potential advantages of robotic radical gastrectomy for gastric adenocarcinoma in comparison with conventional laparoscopic approach: a single institutional retrospective comparative cohort study. Surg Endosc 2015;29:673-685.
doi: 10.1007/s00464-014-3718-0
Nakamura K, Suda K, Suzuki A, Nakauchi M, Shibasaki S, Kikuchi K, Nakamura T, Kadoya S, Inaba K, Uyama I. Intracorporeal isosceles right triangle-shaped anastomosis in totally laparoscopic distal gastrectomy. Surg Laparosc Endosc Percutan Tech 2018;28:193-201.
pubmed: 29738380
Shinohara T, Satoh S, Kanaya S, Ishida Y, Taniguchi K, Isogaki J, Inaba K, Yanaga K, Uyama I. Laparoscopic versus open D2 gastrectomy for advanced gastric cancer: a retrospective cohort study. Surg Endosc 2013;27:286-294.
doi: 10.1007/s00464-012-2442-x
Shibasaki S, Suda K, Nakauchi M, Kikuchi K, Kadoya S, Ishida Y, Inaba K, Uyama I. Robotic valvuloplastic esophagogastrostomy using double flap technique following proximal gastrectomy: technical aspects and short-term outcomes. Surg Endosc 2017;31:4283-4297.
doi: 10.1007/s00464-017-5489-x
Tanaka T, Suda K, Inaba K, Umeki Y, Gotoh A, Ishida Y, Uyama I. Impact of frailty on postoperative outcomes for laparoscopic gastrectomy in patients older than 80 years. Ann Surg Oncol 2019;26: 4016-4026.
doi: 10.1245/s10434-019-07640-0
Nomura E, Lee SW, Kawai M, Yamazaki M, Nabeshima K, Nakamura K, Uchiyama K. Functional outcomes by reconstruction technique following laparoscopic proximal gastrectomy for gastric cancer: double tract versus jejunal interposition. World J Surg Oncol 2014;12:20.
doi: 10.1186/1477-7819-12-20
Okabe H, Obama K, Tanaka E, Tsunoda S, Akagami M, Sakai Y. Laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis using a knifeless endoscopic linear stapler. Gastric cancer 2013;16:268-274.
doi: 10.1007/s10120-012-0181-2
Mori T, Kimura T, Kitajima M. Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan. Minim Invasive Ther Allied Technol 2010;19:18-23.
doi: 10.3109/13645700903492969
Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma. The 15th Edition. Tokyo: KANEHARA & CO., LTD., 2017.
World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 2000;894:i-xii, 1-253.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-213.
doi: 10.1097/01.sla.0000133083.54934.ae
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-196.
doi: 10.1097/SLA.0b013e3181b13ca2
Katai H, Mizusawa J, Katayama H, Kunisaki C, Sakuramoto S, Inaki N, Kinoshita T, Iwasaki Y, Misawa K, Takiguchi N, Kaji M, Okitsu H, Yoshikawa T, Terashima M. Single-arm confirmatory trial of laparoscopy-assisted total or proximal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group study JCOG1401. Gastric Cancer 2019; 22:999-1008.
doi: 10.1007/s10120-019-00929-9
Morris-Stiff G, Jones R, Mitchell S, Barton K, Hassn A. Retraction transaminitis: an inevitable but benign complication of laparoscopic fundoplication. World J Surg 2008;32:2650-2654.
doi: 10.1007/s00268-008-9744-0
Shinohara T, Kanaya S, Yoshimura F, Hiramatsu Y, Haruta S, Kawamura Y, Giacopuzzi S, Fujita T, Uyama I. A protective technique for retraction of the liver during laparoscopic gastrectomy for gastric adenocarcinoma: using a Penrose drain. J Gastrointest Surg 2011;15:1043-1048.
doi: 10.1007/s11605-010-1301-0
Saeki H, Oki E, Kawano H, Ando K, Ida S, Kimura Y, Morita M, Kusumoto T, Ikeda T, Maehara Y. Newly developed liver-retraction method for laparoscopic gastric surgery using a silicone disc: the phi-shaped technique. J Am Coll Surg 2013;216:e43-46.
doi: 10.1016/j.jamcollsurg.2013.02.005
Sakaguchi Y, Ikeda O, Toh Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, Ohga T, Adachi E, Okamura T. New technique for the retraction of the liver in laparoscopic gastrectomy. Surg Endosc 2008;22:2532-2534.
doi: 10.1007/s00464-008-9801-7
Lee SH, Kim KH, Choi CW, Kim SJ, Kim DH, Choi CI, Jeon TY, Kim DH, Hwang SH. Atraumatic liver retraction using nelaton catheters during totally laparoscopic gastrectomy. Surg Laparosc Endosc Percutan Tech 2017;27:485-490.
doi: 10.1097/SLE.0000000000000489
Shibao K, Higure A, Yamaguchi K. Disk suspension method: a novel and safe technique for the retraction of the liver during laparoscopic surgery (with video). Surg Endosc 2011;25:2733-2737.
doi: 10.1007/s00464-011-1614-4
Yoshikawa K, Shimada M, Higashijima J, Nakao T, Nishi M, Takasu C, Kashihara H, Eto S. Combined liver mobilization and retraction: a novel technique to obtain the optimal surgical field during laparoscopic total gastrectomy. Asian J Endosc Surg 2016;9:111-115.