Feasibility of augmented rectangle technique in laparoscopic distal gastrectomy: comparison with hemi-double stapling technique in a single-center retrospective cohort study View Full Text


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Article Info

DATE

2021-11-23

AUTHORS

Ryohei Nishiguchi, Takao Katsube, Takeshi Shimakawa, Shinichi Asaka, Miki Miyazawa, Kentaro Yamaguchi, Minoru Murayama, Takebumi Usui, Hajime Yokomizo, Seiji Ohigashi, Shunichi Shiozawa

ABSTRACT

PurposeAugmented 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... »

PAGES

365-376

References to SciGraph publications

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  • 2018-04-09. Association Between Circular Stapler Diameter and Stricture Rates Following Gastrointestinal Anastomosis: Systematic Review and Meta-analysis in WORLD JOURNAL OF SURGERY
  • 2017-06-06. Subcutaneous adiposity is an independent predictor of mortality in cancer patients in BRITISH JOURNAL OF CANCER
  • 2016-01-28. Body composition changes after totally laparoscopic distal gastrectomy with delta-shaped anastomosis: a comparison with conventional Billroth I anastomosis in SURGICAL ENDOSCOPY
  • 2002-06. Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification in GASTRIC CANCER
  • 2014-11-27. Delta-shaped anastomosis, a good substitute for conventional Billroth I technique with comparable long-term functional outcome in totally laparoscopic distal gastrectomy in SURGICAL ENDOSCOPY
  • 2020-08-11. Delta-shaped gastroduodenostomy after totally laparoscopic distal gastrectomy for gastric cancer: comparative study of original and modified methods in SURGICAL ENDOSCOPY
  • 2018-06-18. Augmented rectangle technique for Billroth I anastomosis in totally laparoscopic distal gastrectomy for gastric cancer in SURGICAL ENDOSCOPY
  • 2013-03-14. Comparing the short-term outcomes of totally intracorporeal gastroduodenostomy with extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer: a single surgeon’s experience and a rapid systematic review with meta-analysis in SURGICAL ENDOSCOPY
  • 2008-03-07. Modified hemi-double-stapling technique combined with the temporal abdominal wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy in SURGICAL ENDOSCOPY
  • 2019-08-05. Comparison of the intracorporeal triangular and delta-shaped anastomotic techniques in totally laparoscopic distal gastrectomy for gastric cancer: an analysis with propensity score matching in SURGICAL ENDOSCOPY
  • 2016-11-18. A comparative study of delta-shaped and conventional Billroth I anastomosis after laparoscopic distal gastrectomy for gastric cancer in SURGICAL ENDOSCOPY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00423-021-02374-8

    DOI

    http://dx.doi.org/10.1007/s00423-021-02374-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1142740512

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34812938


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    26 schema:description PurposeAugmented 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.
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    33 schema:keywords ART group
    34 Billroth I reconstruction
    35 HD group
    36 I reconstruction
    37 MethodsClinical data
    38 ResultsBaseline characteristics
    39 aim
    40 anastomosis
    41 anastomotic stoma
    42 area
    43 better nutritional recovery
    44 blood loss
    45 cancer
    46 characteristics
    47 cohort study
    48 comparison
    49 course
    50 data
    51 decrease
    52 distal gastrectomy
    53 endoscopic findings
    54 factor 1
    55 factors
    56 fat area
    57 feasibility
    58 findings
    59 food
    60 food passage
    61 gastrectomy
    62 gastric cancer
    63 group
    64 hemi-double stapling technique
    65 hospital stay
    66 intracorporeal anastomosis
    67 laparoscopic distal gastrectomy
    68 loss
    69 nutritional factors
    70 nutritional recovery
    71 outcomes
    72 passage
    73 patients
    74 percent decrease
    75 perioperative course
    76 postoperative endoscopic findings
    77 postoperative hospital stay
    78 reconstruction
    79 recovery
    80 rectangle technique
    81 residual food
    82 retrospective cohort study
    83 short-term outcomes
    84 single-center retrospective cohort study
    85 stapling technique
    86 stay
    87 stomata
    88 study
    89 surgery
    90 surgical outcomes
    91 technique
    92 terms
    93 usefulness
    94 visceral fat area
    95 wide anastomotic stoma
    96 years
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