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- Title
Evaluation of the delta-shaped anastomosis in laparoscopic distal gastrectomy: midterm results of a comparison with Roux-en-Y anastomosis.
- Authors
Kitagami, Hidehiko; Morimoto, Mamoru; Nozawa, Masashi; Nakamura, Kenichi; Tanimura, Shinya; Murakawa, Katsuhiko; Murakami, Yoshihiro; Kikuchi, Kenji; Ushigome, Hajime; Sato, Leo; Yamamoto, Minoru; Shimizu, Yasunobu; Hayakawa, Tetsushi; Tanaka, Moritsugu; Hirano, Satoshi
- Abstract
Background: Various methods of reconstruction after laparoscopic distal gastrectomy (LDG) have been developed and published, whereas only a limited number of reports are available on the utility of the delta-shaped anastomosis (Delta). This study compared Delta and Roux-en-Y anastomoses (RY), with the aim to clarify the utility of Delta. Methods: Stage 1 gastric cancer patients who had undergone LDG with Delta (group D, n = 68) and those who had undergone LDG with RY (group RY, n = 60) were compared in terms of operative outcomes, postoperative clinical symptoms, gastrointestinal fiberscopic findings, and changes in body weight. Results: Both the operative and anastomotic times were significantly shorter in group D (230 and 13 min, respectively) than in group RY (258 and 38 min, respectively) ( p < 0.001). Among the complications observed at the anastomotic site, obstruction was seen in one group D patient and two group RY patients but was relieved with conservative management. Postoperative clinical symptoms were reported for 26.4 % of the group D patients but had decreased to 5.9 % 1 year later. Group RY yielded similar results. Upper gastrointestinal fiberscopy performed 1 year postoperatively showed no intergroup differences in the incidence of gastritis or residual retention and a significantly more frequent occurrence of bile reflux in group D. Postoperative weight changes did not differ between the two groups. Conclusions: Delta reconstruction after LDG is a safe and effective procedure that is totally laparoscopic, less time consuming, and associated with a favorable postoperative course and a better quality of life.
- Subjects
GASTRECTOMY; LAPAROSCOPIC surgery; SURGICAL complications; QUALITY of life; SURGICAL anastomosis
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2014, Vol 28, Issue 7, p2137
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-014-3445-6