Laparoscopic mechanical latero-lateral esophagojejunostomy after total gastrectomy for cancer in the elderly: technical notes and results.

BACKGROUND: The realization of an esophagojejunostomy is a critical step in total gastrectomy. Several techniques based on a Roux-En-Y restoration of gastrointestinal continuity were described with similar results. We report our laparoscopic experience in intracorporeal esophagojejunostomy. METHODS: Adults who underwent laparoscopic total gastrectomy for cancer with latero-lateral (functional termino-terminal) Roux en Y intracorporeal esophagojejunostomy with linear stapler from January 2014 to December 2018 were included. Demographics, intra- and postoperative outcomes including 30-day readmissions and mortality were considered. RESULTS: Thirty-two patients were included. Nodal dissection D1 was 16. Median operative time was 280'. Median blood loss was 200 mL. Fluid oral intake is usually resumed on the second postoperative day and soft solid diet is started on the third postoperative day. Three patients had minimal anastomotic leakage and they underwent nonoperative management. Median postoperative stay was 8.5 days. CONCLUSIONS: This technique may improve the ergonomics of esophagojejunostomy creation. The procedure is suitable for experienced laparoscopic surgeons.

Anesthesia Experience for Open Gastrostomy with Ultrasound-Guided Erector Spinae Plane Block: A Case Report.

From the first description in 2016 till today, hundreds of studies have extensively presented Erector Spinae Plane block as an excellent perioperative analgesic technique especially in a multimodal pain management scenario. Only in few cases, this technique was used alone to provide surgical anesthesia.