Ontology type: schema:ScholarlyArticle
2021-11-23
AUTHORSRyohei Nishiguchi, Takao Katsube, Takeshi Shimakawa, Shinichi Asaka, Miki Miyazawa, Kentaro Yamaguchi, Minoru Murayama, Takebumi Usui, Hajime Yokomizo, Seiji Ohigashi, Shunichi Shiozawa
ABSTRACTPurposeAugmented rectangle technique (ART) anastomosis is a totally intracorporeal anastomosis of laparoscopic distal gastrectomy (LDG), Billroth I (B1) reconstruction for gastric cancer, which secures a wide anastomotic stoma. Since the conventional extracorporeal hemi-double stapling technique (HD) may have a narrow anastomotic stoma, our aim of this study was to evaluate the feasibility and usefulness of ART anastomosis by comparing the surgical outcomes with HD anastomosis.MethodsClinical data of 89 patients undergoing LDG with B1 reconstruction were retrospectively collected. Patients were divided into ART group (n = 40) and HD group (n = 49). Surgical outcomes including short-term outcomes, postoperative endoscopic findings, and nutritional factors 1 year after surgery were compared between the groups.ResultsBaseline characteristics were similar between the groups. In terms of short-term outcomes, blood loss was less (11.5 mL vs 40 mL, P = 0.011) and postoperative hospital stay was shorter (10 days vs 12 days, P = 0.022) in the ART group. In terms of endoscopic findings, residual food was less (P = 0.032) in the ART group. In terms of nutritional factors, percent decrease of visceral fat area (− 27.6% vs − 40.5%, P = 0.049) and subcutaneous fat area (− 25.7% vs − 39.3%, P = 0.050) 1 year after surgery attenuated in the ART group.ConclusionsART anastomosis is superior in perioperative course such as postoperative hospital stay. Moreover, a better nutritional recovery is expected by securing a wide anastomotic stoma leading to a favorable food passage. More... »
PAGES365-376
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DOIhttp://dx.doi.org/10.1007/s00423-021-02374-8
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