Comparison of Total Gastrectomy in Open and Laparoscopic Approach. Systematic Review of Literature

Rostislav Pavlov, Shpektorovskyy Illya, Roman Ishenko, Andrew Pavlenko and Alex Sakharov

Department of Oncology, Saint-Petersburg University Clinic of Advanced Medical Technologies, Russia Dnipropetrovsk State Medical Academy of Health Ministry of Ukraine, Ukraine Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of FMBA of Russia, Russia

^*Correspondance to: Rostislav Pavlov 

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Abstract:

Currently, there are more than 70 types of restoration of Gastro Intestinal Tract (GIT) continuity. Reconstruction of the digestive tract is an important part of surgery on par with lymph node dissection and it must have the following characteristics: Gradual emptying into the small intestine, prevention of reflux esophagi is and dumping syndrome, small reservoir size, and reconstructive operative procedures should be relatively uncomplicated and not time-consuming. The technique of GIT reconstruction is the determining factor of postoperative quality of life for the patients. According to the Japanese guidelines, there’re two types of re-construction: With preservation of the duodenal passage and without it. The most known techniques in the duodenal passage exclusion group are Roux-en-Y reconstruction and Roux-en-Y reconstruction with pouch formation. In the duodenal passage preservation group interposition of the jejunum with and without pouch formation are the most common. Currently, Roux-en-Y reconstruction is the preferred technique. The use of Rouxen-Y reconstruction with a pouch to recover the initial anatomical structure significantly decreases the incidence of dumping syndrome and doesn’t increase the number of postoperative complications or mortality, operative time, hospitalization time, and significantly increases patient’s quality of life. For laparoscopic total gastrectomy, it was shown that intracorporeal anastomosis has a better cosmetic appearance, it’s safer, technically feasible, less invasive compared to the extracorporeal anastomosis. Reconstruction using the Orville device should be used in patients with tumors of the cardia or lower third of the esophagus because anastomosis can be formed high in the mediastinum which increases the probability of negative proximal resection margin after gastrectomy.

Keywords:

Gastric cancer; GI reconstruction; Total gastrectomy; Laparoscopic total gastrectomy

Cite the Article:

Pavlov R, Illya S, Ishenko R, Pavlenko A, Sakharov A. Comparison of Total Gastrectomy in Open and Laparoscopic Approach. Systematic Review of Literature. World J Surg Surgical Res. 2019; 2: 1151..