Efficacy of Roux-en-Y Reconstruction Using Two Circular Staplers after Subtotal Gastrectomy: Results from a Pilot Study Comparing with Billroth-I Reconstruction.
10.5230/jgc.2011.11.4.219
- Author:
Tae Gyun KIM
1
;
Hoon HUR
;
Chang Wook AHN
;
Yi XUAN
;
Yong Kwan CHO
;
Sang Uk HAN
Author Information
1. Department of Surgery, Ajou University School of Medicine, Suwon, Korea. hhcmc75@naver.com
- Publication Type:Clinical Trial ; Original Article ; Controlled Clinical Trial
- Keywords:
Stomach neoplasms;
Gastrectomy;
Reconstructive surgical procedure
- MeSH:
Anastomosis, Roux-en-Y;
Bile;
Bile Reflux;
Gastrectomy;
Gastric Stump;
Hand;
Humans;
Pilot Projects;
Reconstructive Surgical Procedures;
Retrospective Studies;
Stomach Neoplasms
- From:Journal of Gastric Cancer
2011;11(4):219-224
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy. MATERIALS AND METHODS: From December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux. RESULTS: No significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019). CONCLUSIONS: When compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.
