Journal of Gastric Cancer

  • 제11권4호
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  • Pages.212-218
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  • 2011
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Intracorporeal Anastomosis Using Linear Stapler in Laparoscopic Distal Gastrectomy: Comparison between Gastroduodenostomy and Gastrojejunostomy

  • Lee, Hak-Woo (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Hyoung-Il (Department of Surgery, Yonsei University College of Medicine) ;
  • An, Ji-Yeong (Department of Surgery, Yonsei University College of Medicine) ;
  • Cheong, Jae-Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Lee, Kang-Young (Department of Surgery, Yonsei University College of Medicine) ;
  • Hyung, Woo-Jin (Department of Surgery, Yonsei University College of Medicine) ;
  • Noh, Sung-Hoon (Department of Surgery, Yonsei University College of Medicine)
  • 투고 : 2011.09.30
  • 심사 : 2011.10.26
  • 발행 : 2011.12.30
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초록

Purpose: Intracorporeal anastomosis during laparoscopic gastrectomy is becoming increasingly prevalent. However, selection of the anastomosis method after laparoscopic distal gastrectomy is equivocal because of a lack of technical feasibility and safety. We compared intracorporeal gastroduodenostomy with gastrojejunostomy using linear staplers to evaluate the technical feasibility and safety of intracorporeal anastomoses as well as its' minimally invasiveness. Materials and Methods: Retrospective analyses of a prospectively collected database for gastric cancer revealed 47 gastric cancer patients who underwent laparoscopic distal gastrectomy with either intracorporeal gastroduodenostomy or gastrojejunostomy from March 2011 to June 2011. Perioperative outcomes such as operation time, postoperative complication, and hospital stay were compared according to the type of anastomosis. Postoperative inflammatory response was also compared between the two groups using white blood cell count and high sensitivity C-reactive protein. Results: Among the 47 patients, 26 patients received gastroduodenostomy, whereas 21 patients received gastrojejunostomy without open conversion or additional mini-laparotomy incision. There was no difference in mean operation time, blood loss, and length of postoperative hospital stays. There was no statistically significant difference in postoperative complication or mortality between two groups. However, significantly more staplers were used for gastroduodenostomy than for gastrojejunostomy (n=6) than for gastroduodenostomy and (n=5). Conclusions: Intracorporeal anastomosis during laparoscopic gastrectomy using linear stapler, either gastroduodenostomy or gastrojejunostomy, shows comparable and acceptable early postoperative outcomes and are safe and feasible. Therefore, surgeons may choose either anastomosis method as long as oncological safety is guaranteed.

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참고문헌

  1. Jeong O, Park YK. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 2011;11:69-77. https://doi.org/10.5230/jgc.2011.11.2.69
  2. Hyung WJ, Kim SS, Choi WH, Cheong JH, Choi SH, Kim CB, et al. Changes in treatment outcomes of gastric cancer surgery over 45 years at a single institution. Yonsei Med J 2008;49:409-415. https://doi.org/10.3349/ymj.2008.49.3.409
  3. Song KY, Park CH, Kang HC, Kim JJ, Park SM, Jun KH, et al. Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study. J Gastrointest Surg 2008;12:1015-1021. https://doi.org/10.1007/s11605-008-0484-0
  4. Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, et al. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg 2002;195:284-287. https://doi.org/10.1016/S1072-7515(02)01239-5
  5. Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer 2011;14:365-371. https://doi.org/10.1007/s10120-011-0054-0
  6. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma - 2nd English edition - Gastric Cancer 1998;1:10-24.
  7. Hyung WJ, Song C, Cheong JH, Choi SH, Noh SH. Factors influencing operation time of laparoscopy-assisted distal subtotal gastrectomy: analysis of consecutive 100 initial cases. Eur J Surg Oncol 2007;33:314-319. https://doi.org/10.1016/j.ejso.2006.11.010
  8. Kim HI, Hyung WJ, Lee CR, Lim JS, An JY, Cheong JH, et al. Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy. Surg Endosc 2011;25:958-963. https://doi.org/10.1007/s00464-010-1288-3
  9. Lee SW, Bouras G, Nomura E, Yoshinaka R, Tokuhara T, Nitta T, et al. Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes. Surg Endosc 2010;24:1774-1780. https://doi.org/10.1007/s00464-009-0803-x
  10. Hyung WJ, Lim JS, Cheong JH, Kim J, Choi SH, Song SY, et al. Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy. Surg Endosc 2005;19:1353-1357. https://doi.org/10.1007/s00464-004-8196-3
  11. Lee HJ, Kim HH, Kim MC, Ryu SY, Kim W, Song KY, et al; Korean Laparoscopic Gastrointestinal Surgery Study Group. The impact of a high body mass index on laparoscopy assisted gastrectomy for gastric cancer. Surg Endosc 2009;23:2473-2479. https://doi.org/10.1007/s00464-009-0419-1
  12. Song KY, Kim SN, Park CH. Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects. Surg Endosc 2008;22:655-659. https://doi.org/10.1007/s00464-007-9431-5
  13. Park DJ, Lee HJ, Kim HH, Yang HK, Lee KU, Choe KJ. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg 2005;92:1099-1102. https://doi.org/10.1002/bjs.4952
  14. Sah BK, Chen MM, Yan M, Zhu ZG. Gastric cancer surgery: Billroth I or Billroth II for distal gastrectomy? BMC Cancer 2009;9:428. https://doi.org/10.1186/1471-2407-9-428

피인용 문헌

  1. Intracorporeal Anastomosis in Laparoscopic Gastric Cancer Surgery vol.12, pp.3, 2012, https://doi.org/10.5230/jgc.2012.12.3.133
  2. Totally Laparoscopic Roux-en-Y Gastrojejunostomy after Laparoscopic Distal Gastrectomy: Analysis of Initial 50 Consecutive Cases of Single Surgeon in Comparison with Totally Laparoscopic Billroth I Re vol.55, pp.1, 2011, https://doi.org/10.3349/ymj.2014.55.1.162
  3. Comparison of perioperative surgical outcomes between a bipolar device and an ultrasonic device during laparoscopic gastrectomy for gastric cancer vol.29, pp.3, 2011, https://doi.org/10.1007/s00464-014-3702-8
  4. Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes vol.14, pp.None, 2016, https://doi.org/10.1186/s12957-016-0868-7
  5. T-shaped Modified Delta Anastomosis as a Simple Intracorporeal Gastroduodenostomy vol.21, pp.2, 2011, https://doi.org/10.7602/jmis.2018.21.2.57
  6. Revisiting Laparoscopic Reconstruction for Billroth 1 Versus Billroth 2 Versus Roux-en-Y After Distal Gastrectomy: A Systematic Review and Meta-Analysis in the Modern Era vol.43, pp.6, 2011, https://doi.org/10.1007/s00268-019-04943-x
  7. Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer vol.33, pp.7, 2011, https://doi.org/10.1007/s00464-019-06772-4
  8. Lower rate of conversion using robotic-assisted surgery compared to laparoscopy in completion total gastrectomy for remnant gastric cancer vol.34, pp.2, 2011, https://doi.org/10.1007/s00464-019-06838-3