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Unaided Stapling Technique for Pure Single-Incision Distal Gastrectomy in Early Gastric Cancer: Unaided Delta-Shaped Anastomosis and Uncut Roux-en-Y Anastomosis.

Suh YS, Park JH, Kim TH, Huh YJ, Son YG, Yang JY, Kong SH, Lee HJ, Yang HK - J Gastric Cancer (2015)

Bottom Line: Mean operation times were 214.5±36.2 minutes for uDelta and 240.8±65.9 minutes for RY, which was not significantly different.Average length of hospital stay was 8.2±1.9 days in the uDelta group and 7.2±0.8 days in the RY group (P=0.320).After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Intracorporeal anastomosis is the most difficult procedure during pure single-incision distal gastrectomy (SIDG) that affects its generalization. We introduced unaided delta-shaped anastomosis (uDelta), a novel anastomosis technique, for gastroduodenostomy after pure SIDG, and compared the results with those of previously reported Roux-en-Y anastomosis (RY).

Materials and methods: Between March 2014 and March 2015, SIDG with D1+ lymph node dissection was performed for early gastric cancer through a 2.5-cm transumbilical incision without any additional port. uDelta was performed by the operator alone, without any intracorporeal assistance.

Results: uDelta was performed on 11 patents, and uncut RY was performed on 5-patients without open or multiport conversion. R0 resection was performed in all cases. No significant differences were observed in mean age and body mass index between patients who underwent uDelta or RY. Mean operation times were 214.5±36.2 minutes for uDelta and 240.8±65.9 minutes for RY, which was not significantly different. Reconstruction time for uDelta was shorter than that for RY, with marginal statistical significance (26.1±8.3 minutes vs. 38.0±9.1 minutes, P=0.05). There were no intraoperative transfusions, 30-day mortality, or anastomosis-related complications in either group. Average length of hospital stay was 8.2±1.9 days in the uDelta group and 7.2±0.8 days in the RY group (P=0.320).

Conclusions: After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.

No MeSH data available.


Related in: MedlinePlus

Median number of estimated lymph nodes (LNs) at each lymph node station after total cases of single-incision distal gastrectomy with D1+ lymph node dissection.
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Figure 2: Median number of estimated lymph nodes (LNs) at each lymph node station after total cases of single-incision distal gastrectomy with D1+ lymph node dissection.

Mentions: The uDelta procedure was performed in 11 patients, and RY was performed in 5 patients (Table 1). None of the patients required open or multiport conversion, and the procedure was completed without any intraoperative complications or transfusions. R0 resection with a negative resection margin was achieved in all patients. Based on the 7th AJCC TNM staging system, postoperative pathology revealed stage I gastric adenocarcinoma in 13 patients, neuroendocrine tumor without lymph node metastasis in 1 patient, and mixed adenoneuroendocrine carcinoma in 2 patients.17 There was no significant difference in age, sex, and body mass index between the uDelta and RY groups. Fig. 2 shows the number of examined lymph nodes at each lymph node station after total 16 cases of SIDG with D1+ lymph node dissection. Fig. 3 shows a series of average operation times for each SIDG case, along with each patient's body mass index. Table 2 shows that the operation time for the uDelta procedure was shorter than that for the RY procedure (214.5±36.2 minutes vs. 240.8±65.9 minutes), although the difference was not statistically significant (P=0.661). In addition, reconstruction time for uDelta was significantly shorter than that for RY (26.1±8.3 minutes vs. 38.0±9.1 minutes), and this difference was marginally significant (P=0.05).


Unaided Stapling Technique for Pure Single-Incision Distal Gastrectomy in Early Gastric Cancer: Unaided Delta-Shaped Anastomosis and Uncut Roux-en-Y Anastomosis.

Suh YS, Park JH, Kim TH, Huh YJ, Son YG, Yang JY, Kong SH, Lee HJ, Yang HK - J Gastric Cancer (2015)

Median number of estimated lymph nodes (LNs) at each lymph node station after total cases of single-incision distal gastrectomy with D1+ lymph node dissection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496436&req=5

Figure 2: Median number of estimated lymph nodes (LNs) at each lymph node station after total cases of single-incision distal gastrectomy with D1+ lymph node dissection.
Mentions: The uDelta procedure was performed in 11 patients, and RY was performed in 5 patients (Table 1). None of the patients required open or multiport conversion, and the procedure was completed without any intraoperative complications or transfusions. R0 resection with a negative resection margin was achieved in all patients. Based on the 7th AJCC TNM staging system, postoperative pathology revealed stage I gastric adenocarcinoma in 13 patients, neuroendocrine tumor without lymph node metastasis in 1 patient, and mixed adenoneuroendocrine carcinoma in 2 patients.17 There was no significant difference in age, sex, and body mass index between the uDelta and RY groups. Fig. 2 shows the number of examined lymph nodes at each lymph node station after total 16 cases of SIDG with D1+ lymph node dissection. Fig. 3 shows a series of average operation times for each SIDG case, along with each patient's body mass index. Table 2 shows that the operation time for the uDelta procedure was shorter than that for the RY procedure (214.5±36.2 minutes vs. 240.8±65.9 minutes), although the difference was not statistically significant (P=0.661). In addition, reconstruction time for uDelta was significantly shorter than that for RY (26.1±8.3 minutes vs. 38.0±9.1 minutes), and this difference was marginally significant (P=0.05).

Bottom Line: Mean operation times were 214.5±36.2 minutes for uDelta and 240.8±65.9 minutes for RY, which was not significantly different.Average length of hospital stay was 8.2±1.9 days in the uDelta group and 7.2±0.8 days in the RY group (P=0.320).After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Intracorporeal anastomosis is the most difficult procedure during pure single-incision distal gastrectomy (SIDG) that affects its generalization. We introduced unaided delta-shaped anastomosis (uDelta), a novel anastomosis technique, for gastroduodenostomy after pure SIDG, and compared the results with those of previously reported Roux-en-Y anastomosis (RY).

Materials and methods: Between March 2014 and March 2015, SIDG with D1+ lymph node dissection was performed for early gastric cancer through a 2.5-cm transumbilical incision without any additional port. uDelta was performed by the operator alone, without any intracorporeal assistance.

Results: uDelta was performed on 11 patents, and uncut RY was performed on 5-patients without open or multiport conversion. R0 resection was performed in all cases. No significant differences were observed in mean age and body mass index between patients who underwent uDelta or RY. Mean operation times were 214.5±36.2 minutes for uDelta and 240.8±65.9 minutes for RY, which was not significantly different. Reconstruction time for uDelta was shorter than that for RY, with marginal statistical significance (26.1±8.3 minutes vs. 38.0±9.1 minutes, P=0.05). There were no intraoperative transfusions, 30-day mortality, or anastomosis-related complications in either group. Average length of hospital stay was 8.2±1.9 days in the uDelta group and 7.2±0.8 days in the RY group (P=0.320).

Conclusions: After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.

No MeSH data available.


Related in: MedlinePlus