Application Of The OrVil^TM Circular Stapler In LaparoscopicTotal Gastrectomy Surgery

ObjectiveTo explore the feasibility and safety of OrVilTM Circular Stapler in laparoscopic radical total gastrectomy by comparing with laparoscopic assisted radical total gastrectomy using purse string suture nail drill for esophagojejunostomy.MethodsThe clinical data of 73 patients with gastric cancer who underwent laparoscopic radical total gastrectomy（LRTG）from July 2015 to June 2017 in general surgery of our Hospital were retrospectively analyzed.According to inclusion and exclusion criteria,37 patients in OrVilTM group and 36 patients in purse string suture group were selected.Clinical data of two groups were compared and analyzed.General data such as gender,age,BMI,and intraoperative and postoperative related data such as operation time（OT）,esophagojejunostomy time,estimated blood loss（EBL）,number of lymph node dissection,length of abdominal incision,first postoperative exhaust time,postoperative complications,length of hospital stay（LOS）,and total hospitalization costs.ResultsA total of 73 patients underwent laparoscopic total gastric surgery were enrolled in this study.Among them,37 patients were in OrVilTM group,and 36 patients in purse string suture group were in OrVilTM group.There were no significant differences in gender,age,BMI,Past medical history and TNM stage between the two groups（P>0.05）.OrVilTM group had shorter esophagojejunostomy time（23.3±3.3 vs 29.513.3 min,P<0.001）,less EBL（119.2152.7 vs 183.1 176.8 ml,P<0.001）and shorter incision length（7.6±1.5 vs 12.812₅ cm,P<0.001）.There was no significant difference in the number of lymph nodes and OT between the two groups（P>0.05）..The first exhaust time was shorter（3.5±0.7 vs 4.0±1.0 days,P=0.012）,and the LOS of OrVilTM group was shorter（10.8±1.5 vs 12.4±3.5 days,P=0.035）,while the hospitalization cost was higher（P=0.042）.The postoperative complication rate of the two groups was similar（16.2%vs 22.2%,P=0.295）.ConclusionsThe application of OrVilTM Circular Stapler,technique in laparoscopic radical total gastrectomy is safe and feasible,and the short-term effect is satisfactory.