In:
Asian Journal of Endoscopic Surgery, Wiley, Vol. 10, No. 2 ( 2017-05), p. 137-142
Abstract:
Laparoscopy‐assisted distal gastrectomy is one of the major treatments for early stage gastric cancer, particularly in the East Asia. In this method, extracorporeal anastomosis is performed via a small laparotomy wound, but excessive tissue traction may be encountered during the anastomotic procedure. Therefore, we developed an original procedure for extracorporeal Billroth‐I reconstruction: end‐to‐end stapling gastroduodenostomy with complete double stapling technique. This procedure aims to reduce the problems related to maneuvers through a small laparotomy. Methods An end‐to‐end anastomosis is constructed on the transection line using a circular stapler inserted from the distal end of the greater curvature of the remnant stomach. Short‐term outcomes were reviewed in 218 consecutive patients who underwent complete double stapling technique reconstruction after laparoscopy‐assisted distal gastrectomy between 2002 and 2012. Findings from GI endoscopy were reviewed in 110 patients. Results The mean operative time was 216 min, and mean blood loss was 163 mL. There was no conversion to the open surgery and no operative death. Eight patients (3.6%) had anastomosis‐related postoperative complications. In follow‐up endoscopic examinations 1 year after surgery, grade 3 or higher residual food was seen in 17.2% of patients. Gastritis extending to the entire remnant stomach was observed in 8.2% of patients, and grade 3 gastritis was seen in 2.7%. Los Angeles classification grade A or higher reflux esophagitis was found in 10.9%. Conclusions Billroth‐I reconstruction by the complete double stapling technique is a safe and feasible procedure. This method provides satisfactory short‐term outcomes, including the incidence of reflex remnant gastritis and esophagitis.
Type of Medium:
Online Resource
ISSN:
1758-5902
,
1758-5910
DOI:
10.1111/ases.2017.10.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2503256-2
detail.hit.zdb_id:
2492135-X
