gi-diseases-2018-scientifictracks-abstracts

2 / 8

Page 17
conferenceseries.com
Volume 8 Journal of Gastrointestinal & Digestive System GI Diseases 2018
July 11-12, 2018
July 11-12, 2018 Sydney, Australia
15th International Conference on
Digestive Disorders and Gastroenterology
A long-term surgical outcome of self-pulling and holding purse-string suture technique for intra-
corporeal circular-stapled esophagojejunostomy
Jianjun Du1, 2, Jianbo Shuang1, Jing Li1, Jipeng Li1 and Jin Hua2
1The Fourth Military Medical University, China
2Fudan University, China
Background: Classic esophagojejunostomy using a circular stapler is the most commonly performed standard reconstruction
procedure in open surgery, than this technique should be the preferred method of esophagojejunostomy in laparoscopic
surgery. In circular stapling method, the most difficult steps are placing the purse-string suture and anvil which limit its
widespread applications. To address this problem, we introduced a novel self-pulling and holding technique to place the purse-
string suture for intra-corporeal circular-stapled esophagojejunostomy in laparoscopic surgery.
Methods: Creation of the purse-string suture was performed by hand with assistance of constant self-pulling and holding
of the uncut right esophagus on the transected esophageal end after subtotal circumferential transection (90%) of the distal
esophagus. A needle insertion from the serosal side or the mucosal side of the esophageal lumen was chosen to avoid placing
a backhand stitch in addition to the easy needle insertion from the mucosal side on the posterior esophageal wall. Five-year
follow-up for the patients underwent the procedure was completed.
Results: Between June 2009 and December 2012, 52 patients with gastric cancer underwent consecutive laparoscopic total
gastrectomy using the procedure for intra-corporeal circular-stapled esophagojejunostomy. The mean (±SD) operating time
was 297.1±53.0 minutes and the time of the purse-string suture and anvil placement was 18.3±6.1 minutes. There were three
major postoperative complications: one for anastomotic bleeding, two for ileus. During five-year follow-up periods, there were
no instances of postoperative anastomosis-related complications observed except for one with stenosis.
Conclusions: We believe that this method is feasible and reliable to create the purse-string suture for intra-corporeal circular-
stapled esophagojejunostomy by a long-term follow-up.
Biography
Jianjun Du has completed his MD at the age of 24 years from the Fourth Military Medical University, PhD from the Fourth Military Medical University and
postdoctoral studies from Zhejiang University. He is vice director of general surgery, Huashan Hospital. He has published more than 10 papers in reputed journals
and has been serving as a reviewer of repute.
Jianjun Du ., J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C2-067