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Totally laparoscopic colon surgery/intracorporeal anastomosis

Laparoscopic-assited colon surgery/extracorporeal anastomosis

intracorporeal anastomosis

Quan Wang, Prof.

This is a comparison of totally laparoscopic and laparoscopic-assisted colon cancer resection, a prospective registration study comparing the safety and benefits of the two operations

Colorectal cancer is one of the most common malignant tumors in China. With the advancement of medical science and technology, the treatment of colorectal cancer has become more mature, forming a comprehensive and individualized treatment model focusing on surgery. The promotion of the principles of TME and CME surgery has greatly standardized the operation of colorectal surgery. COLOR II, COREAN and CLASICC studies have all confirmed the safety and effectiveness of laparoscopic colorectal cancer surgery.

In traditional laparoscopic-assisted surgery, a small incision in the abdominal wall is used to assist in trimming the mesangium to remove the specimen, and the anastomosis is completed outside the abdominal wall, which will still cause postoperative incision pain and may lead to complications such as incisional infection and incisional hernia. However, in some obese patients, the mesangium is thick and short. The above operations are more difficult, and may even cause the risk of mesangial tears and bleeding, which will weaken the minimally invasive advantages of laparoscopic surgery.

The total laparoscopic radical resection of colon cancer is performed under laparoscopic free dissection and dissected reconstruction of the operation area. The small incision of the abdominal wall Trocar is used to take out the specimen, which not only guarantees a sufficient range of dissection and resection, but also avoids the troubles caused by the auxiliary abdominal wall incision. Postoperative recovery may be faster, but it also raises questions about the increased risk of infection in the surgical area. Total laparoscopic radical resection of colon cancer still lacks corresponding high-quality clinical research. In response to this problem, this study compares related surgical methods, verifies the safety and effectiveness of the corresponding surgical methods, and provides better guidance for subsequent clinical practice.

Taking laparoscopic-assisted radical resection of colon cancer as a control, the short-term and long-term effects of full laparoscopic radical resection of colon cancer were evaluated, so as to choose a more effective and safe operation method.

Prospective Registration Study of Totally Laparoscopy Versus Laparoscopy Assisted Colon Cancer Surgery

Complication incidence 30 days after operation

the length between the beginning and the end of the whole operation

the mount of blood loss during the whole operation(ml）

Intraoperative conversion rate (conversion to open, conversion to laparoscopic-assisted surgery

Rate of complete mesentery resection (CME)

Postoperative recovery: first exhaust, defecation time, restoring liquid diet, hospitalization days.

The First Hospital of Jilin University

Professor

Rare Diseases

Stomach Neoplasms

Stomach Diseases

Stomach Cancer

Patient group with intracorporeal esophagojejunostomy with linear stapler

Under laparoscopic view, esophagojejunostomy was pereformed with 60mm linear stapler on right side of distal esophagus like as functional end-to-end fashion before esophageal and jejunal resection. Then, three procedures of esophageal resection, common entry hole closure and jejunal resection was performed with a single use of 60mm stapler. Also, jejunojejunostomy was also performed via already made staple entry hole.

Intracorporeal esophagojejunostomy

Seung Wan Ryu, Ph.D.

Laparoscopic gastrectomy became a good option for early gastric cancer. Surgical trend is gradually changed to totally laparoscopic gastrectomy from laparoscopy-assisted gastrectomy requiring mini-laparotomy. Various types of intracorporeal anastomosis have been introduced for esophagojejunostomy during total gastrectomy. We invented a novel anastomosis method using linear stapler for total gastrectomy. Three procedures (Jejunal resection, esophageal resection and closure of common entry hole after anastomosis) was performed with only one stapler. Therefore, the novel method is simple and fast. Also, this new technique is better economically than previously introduced anastomosis using linear stapler because lesser number of stapler is required. We want to demonstrate the feasibility of novel intracorporeal anastomosis method during laparoscopic total gastrectomy.

Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy

Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy: π-shape Esophagojejunostomy, Three-in-one Technique

Anastomotic leakage, intraluminal bleeding, or stenosis were considered as anastomosis related complication

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Prospective Registration Study of Totally Laparoscopy Versus Laparoscopy Assisted Colon Cancer Surgery	NCT04853784	Colon Cancer Surgery Totally Laparos... Intracorporeal ...	intracorporeal ...	18 Years - 80 Years	The First Hospital of Jilin University
Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy	NCT02330913	Gastric Cancer	Intracorporeal ...	20 Years - 80 Years	Keimyung University Dongsan Medical Center
Prospective Registration Study of Totally Laparoscopy Versus Laparoscopy Assisted Colon Cancer Surgery	NCT04853784	Colon Cancer Surgery Totally Laparos... Intracorporeal ...	intracorporeal ...	18 Years - 80 Years	The First Hospital of Jilin University
Novel Esophago-Jejunal Anastomosis Method During Totally Laparoscopic Total Gastrectomy	NCT02330913	Gastric Cancer	Intracorporeal ...	20 Years - 80 Years	Keimyung University Dongsan Medical Center

Spots Global Cancer Trial Database for totally laparoscopic