چکیده (انگلیسی):

There has been a recent increase in the use of totally laparoscopic total gastrectomy
(TLTG) for gastric cancer. However, there is no scientific evidence to determine which
esophagojejunostomy (EJS) technique is the best. In addition, both short- and long-term
oncological results of TLTG are inconsistent. We reviewed 25 articles about TLTG for gastric
cancer in which at least 10 cases were included. We analyzed the short-term results, relationships
between EJS techniques and complications, long-term oncological results, and
comparative study results of TLTG. TLTG was performed in a total of 1170 patients. The mortality
rate was 0.7%, and the short-term results were satisfactory. Regarding EJS techniques
and complications, circular staplers (CSs) methods were significantly associated with
leakage (4.7% vs. 1.1%, p < 0.001) and stenosis (8.3% vs. 1.8%, p < 0.001) of the EJS as
compared with the linear stapler method. The long-term oncological prognosis was acceptable
in patients with early gastric cancers and without metastases to lymph nodes. Although
TLTG tended to increase surgical time compared with open total gastrectomy and
laparoscopy-assisted total gastrectomy, it reduced intraoperative blood loss and was expected
to shorten postoperative hospital stay. TLTG is found to be safer and more feasible
than open total gastrectomy and laparoscopy-assisted total gastrectomy. At present, there is
no evidence to encourage performing TLTG for patients with advanced gastric cancer from
the viewpoint of long-term oncological prognosis. Although the current major EJS techniques are CS and linear stapler methods, in this review, CS methods are significantly associated
with leakage and stenosis of the EJS.