KMID : 1141320230380020126
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Kosin Medical Journal 2023 Volume.38 No. 2 p.126 ~ p.133
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Intraoperative tumor localization using a titanium ring strip in totally laparoscopic distal gastrectomy for middle-third gastric cancer
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Park Jae-Kyun
Choi Chang-In Jeon Tae-Young Jung Hyuk-Jae Lee Si-Hak Hwang Sun-Hwi Kim Dae-Hwan
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Abstract
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Background: This study presents a novel technical tip for intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip for totally laparoscopic distal gastrectomy in patients with middle-third gastric cancer and describes the short-term results of its application.
Methods: In total, 42 patients with middle-third gastric cancer who underwent intraoperative tumor localization using a titanium ring strip and determination of the proximal resection line through intraoperative radiography between January 2020 and December 2021 were enrolled in this study. We retrospectively analyzed patients¡¯ prospectively collected clinical, pathological, and surgical data.
Results: Twenty-six men and 16 women with a mean age of 58.3¡¾12.5 years were enrolled. The mean operation time and estimated blood loss were 212.6¡¾43.0 minutes and 122.4¡¾77.6 mL, respectively. The lengths of the proximal and distal resection margin were 2.0¡¾0.4 cm (range, 0.8?3.7 cm) and 10.5¡¾4.1 cm (range, 0.4?20.4 cm), respectively. Roux-en-Y anastomosis was performed in 30 patients, while Billroth II with Braun anastomosis was performed in 12 patients. There were no procedure-related complications, and the mean postoperative hospital stay was 7.2¡¾1.9 days. For all patients, the negative proximal resection margin was confirmed by postoperative pathological examinations.
Conclusions: Intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip is a useful alternative method that can be easily and safely performed. This method is especially useful for patients with middle-third gastric cancer requiring an appropriate proximal resection margin.
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KEYWORD
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Gastrectomy, Laparoscopy, Stomach neoplasms, Surgical anastomosis
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