Application Of Orvil In Laparoscopic Resection Of Cardiac Carcinoma

Background： Although incidence of gastric cancer descended， theincidence of cardiac carcinoma ascended.And resconstruct of digestive tract aftercardiac carcinoma is very difficult.Objective：To Summarize the clinical data of application of orVil in laparoscopicresection of cardiac carcinoma(total gastrectomy) and investigate the feasibility andadvantage of reconstruction of digestive tract after orVil in laparoscopic resection ofcardiac carcinoma (total gastrectomy).Methods： Between March2011and February2012，fifteen patients underwentresconstruct of digestive tract after orVil in laparoscopic resection of cardiaccarcinoma (total gastrectomy) in the second hospital general surgery center.Summarize the clinical data of the fifteen cases of orVil in laparoscopic resection ofcardiac carcinoma (total gastrectomy).Results：Ihe this group, there were no Esophageal jejunum anastomotic leakageand stricture and two patients have lung infection.The length of the resectionesophagus was（4.31±0.52cm）， Operation time was（188.33±11.75m），the meanblood loss during operation was（136.47±20.30ml），Postoperative drainage was（118±36.55ml），Anal exsufflation time was （3.27±0.85d），off-bed activity timewas（2.60±0.71d），Postoperative pain pump used times（0.73±0.92）.According toSiewert classification,SiewertI(1)，SiewertII(3)，SiewertIII(11).High differentiatedadenocarcinoma (2), differentiated adenocarcinoma (1), low differentiatedadenocarcinoma in (7), a signet ring cell carcinoma (5).Clinical pathologic stage,nostage IA、IB in this group, stage II(3)，stage IIIA(7)，stage IIIB(5)，and without stageIV patient.All of the patients do preoperative CT,14cases found primary tumor inpreoperative abdominal CT, the detection rate was93.33%, all of the patients havelymph node metastasis，12cases found lymph node metastasis in preoperativeabdominal CT,the detection rate was80.00%.Besides two cases of lung infection，there was no complications, tumor recurrence or metastasis during3-12months’follow up.Conclusion：（1）The use of the OrVil in laparoscopic assisted cardia carcinoma surgery (total gastrectomy)and reconstruction of digestive tract is safe and does nothave an increased complication rate. It is quicker easier and more safe compared tothe traditional purse-string technique.And it may become the standard surgery forhigh cardia carcinoma one day（.2） Application of orVil in laparoscopic resection ofcardiac carcinoma Can remove the tumor above Gastroesophageal junction,and cannot remove the tumor without orVil,if we want to do it with traditional methods,weshoud do open surgery or abdominothoracicincision. Threfore,expand thelaparoscopic range.