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ORIGINAL RESEARCH article

Front. Surg.
Sec. Visceral Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1385754

Esophagojejunostomy using a circular stapler versus a linear stapler for gastric cardia cancer patients: Impact of upper margin length and tumor size on the survival rate

Provisionally accepted
Maniragaba Dieudonne Maniragaba Dieudonne 1,2Renguang Lv Renguang Lv 1,2Wenjie Xie Wenjie Xie 1,2Qi Liu Qi Liu 1,2Jianwu Jiang Jianwu Jiang 2,3Yang Fu Yang Fu 1,2*
  • 1 Zhengzhou University, Zhengzhou, Henan Province, China
  • 2 First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
  • 3 2Gastrointestinal Surgery Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China., Zhengzhou, China

The final, formatted version of the article will be published soon.

    Background The incidence of gastric cancer is concomitantly rising with gastric cardia cancer worldwide. While the improvement of gastric cancer surgical techniques is glowing, this study assesses the impact of the upper margin length and tumor size on the survival rate for gastric cardia cancer patients who underwent total laparoscopic total gastrectomy(TLTG) or laparoscopic assisted total gastrectomy(LATG). Materials and methods: A total of 63 patients with gastric cardia cancer who underwent laparoscopic total gastrectomy were retro-prospectively collected from January 2021 to May 2023. While assessing the impact of upper margin length and tumor size on the survival rate, esophagojejunostomy using a linear stapler has been compared to a circular stapler. Results:The sixty-three patients met inclusion criteria; 32 (51%) underwent LATG and 31 (49%) underwent TLTG.Their mean age was 65 years (range, 45-77). The blood loss means in LATG and TLTG was 74.69 and 50.16 ml, respectively (p=0.005), and surgery duration was higher in LATG than LATG with respective means of 247min and 222.42 min. (p=0.006). However, the tumor size means (p= 0.5), and upper margin length means (p=0.052) were not significantly different in the LATG and TLTG groups, respectively.The number of resected and assessed lymph node was adequate in the LATG and TLTG groups. The current study still does not find an independent related risk from the upper margin length and tumor size to the survival rate according to the multiple regression analysis (p=0.080). Conclusion:The upper margin length and tumor size do not have a relationship with the survival rate of the compared esophagojejunostomy (EJS) methods. The EJS using a linear stapler requires a shorter surgery duration and less blood loss than EJS using a circular stapler.

    Keywords: Maniragaba Dieudonne1, Renguang Lv2, Wenjie Xie2 †, Qi Liu3, Jianwu Jiang3 †, Yang Fu* 1. Maniragaba Dieudonne, Resident. General Surgery Renguang Lv, Resident. General Surgery Gastric cardia cancer

    Received: 13 Feb 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Dieudonne, Lv, Xie, Liu, Jiang and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yang Fu, Zhengzhou University, Zhengzhou, 450001, Henan Province, China

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