ABSTRACT
Objective: To evaluate the short-term efficacy of R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma. Methods:Data on 10 patients with gas-tric stump cancer were analyzed retrospectively from January 2013 to August 2014. All the patients received R-type jejunal interposi-tion and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma (laparoscope group) in the Lanzhou General Hospital of the Lanzhou Military Area. Laparotomy was performed on 18 cases that com-prised the control group (laparotomy group). The intraoperative and postoperative indicators between these two groups were then com-pared. All the patients were followed-up from 14 to 21 months after the operations. Results:The operations were successfully carried out in all 10 patients (laparoscope group), without performing open operation. The mean operative times, volumes of the intraoperative blood loss, numbers of dissected lymph nodes, frequencies of leaving the bed, days marking the first liquid diet intake, days marking the recovery of gastrointestinal function, and days of hospitalization of the laparoscope group and the laparotomy group were (210.0 ± 30.9) min and (283.9 ± 50.9) min, (90.0 ± 26.7) mL and (277.8 ± 79.1) mL, (19.0 ± 3.6) and (18.8 ± 3.7), (17.3 ± 3.6) h and (75.8 ± 15.7) h, (1.6 ± 0.4) d and (5.7 ± 1.3) d, (3.0 ± 0.8) d and (7.2 ± 1.3) d, and (7.6 ± 1.2) d and (20.8 ± 3.9) d, respectively. Anastomotic stricture, reflux esophagitis, bleeding, leakage, dumping syndrome, or intestinal obstruction was not detected in the laparoscope group. There was no perioperative death. All of the cases exhibited good nutrition situation, and no choking or esophagus burning was reported. Conclusion:R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy is safe and feasible. The operation can improve the quality of life of patients and induce positive short-term therapeutic effects. Laparo-scopic-assisted radical gastrectomy for gastric stump cancer has the same effect as laparotomy.