Aya Isobe, Shinichiro Mori, Yoshiaki Kita, Kenji Baba, Kan Tanabe, Masayuki Yanagi, Takaaki Arigami, Yasuto Uchikado, Kosei Maemura, Masahiko Sakoda, Shoji Natsugoe. Kagoshima University
Objective: Delta-shaped anastomosis was first presented by Kanaya et al in 2002 after totally laparoscopic gastroenterostomy. This procedure has been widely adopted for gastric cancer, however, the report of delta-shaped anastomosis via overlap method for colectomy is few. The aim of this study was to assess safety of modified delta-shaped anastomosis via overlap method using linear staplers for colon cancer.
Methods: Prospectively collected data of 6 patients (1 men, 5 women; mean age 78 years; mean body mass index: BMI 20.8 kg/m2) with colon cancer who underwent anastomosis after colectomy from June 2017 to December 2017 were enrolled. Surgical outcomes, complications and length of hospital stay were assessed.
Surgical procedure: After performing laparoscopic colectomy, modified delta-shaped anastomosis via overlap method using linear staplers was performed extracorporeally or intracorporeally. The proximal terminal ileum (or colon) and the distal colon were transected using linear staplers. The distal terminal ileum (or colon) and the proximal colon were laid in overlap fashion and fixed via some sutures at first. The entry hole was created using an ultrasound scalpel at 3cm distal to proximal terminal ileum (or colon) and 7cm proximal to the distal colon. After two arms of linear stapler inserting each lumens, intestinal walls of opposite side of mesentery were got fired. Finally the common entry hall was closed using a linear cutter stapler in delta-shaped manner. Results: Mean of operative time and blood loss were 202 min and 18 g, respectively. No patient had an intraoperative and postoperative complications. None of patients had unplanned readmissions into hospital within 30 days. There was no mortality. The length of hospital stay was 12 days.
Conclusions: Modified delta-shaped anastomosis via overlap method using linear staplers is a safe procedure for anastomosis after colectomy.
Future directions: This method would be useful for totally laparoscopic colectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91226
Program Number: ETP879
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster