Intracorporeal modified delta-shaped gastroduodenostomy during 2-port distal gastrectomy:technical aspects and short-term outcomes
10.4174/astr.2023.105.3.172
- Author:
Sejin LEE
1
;
Jeong Ho SONG
;
Sung Hyun PARK
;
Minah CHO
;
Yoo Min KIM
;
Woo Jin HYUNG
;
Hyoung-Il KIM
Author Information
1. Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Publication Type:HOW I DO IT
- From:Annals of Surgical Treatment and Research
2023;105(3):172-177
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Surgeons have become increasingly interested in reduced-port gastrectomy to minimize trauma while maintaining oncologic safety. Although gastroduodenostomy has the benefits of better nutritional outcomes and fewer postoperative complications than other types of reconstruction, gastroduodenostomy is not a preferred option for reducedport distal gastrectomy because of technical difficulties. In this study, we describe our intracorporeal modified deltashaped gastroduodenostomy technique, which is easily applicable during 2-port distal gastrectomy.
Methods:We retrospectively reviewed our database of 30 consecutive patients with gastric cancer who underwent 2-port distal gastrectomy with intracorporeal modified delta-shaped gastroduodenostomy from October 2016 to May 2021. In this reduced-port approach, we used a Tropian Single port (TROPIAN TECH) via a 25-mm transumbilical incision and a 12-mm port at the right flank. All anastomoses were performed using a 60-mm endolinear stapler. We used 3 additional sutures to provide proper traction and support for the anastomosis.
Results:Mean ± standard deviation of operation time was 148.9 ± 34.7 minutes; reconstruction time was 13.2 ± 4.6 minutes; estimated blood loss was 29.3 ± 44.4 mL; and length of hospital stay was 4.5 ± 1.2 postoperative days. A total of 11 patients (36.7%) had a Clavien-Dindo grade I or grade II complication, and there were no grade IIIa or higher complications.
Conclusion:Intracorporeal modified delta-shaped gastroduodenostomy was safely performed via a 2-port approach, resulting in acceptable surgical outcomes and no major complications.
