Feasibility of Linear-Shaped Gastroduodenostomy during the Performance of Totally Robotic Distal Gastrectomy

Sang-Uk Han; Bo Wang; 손상용; Hojung Shin; Chul Kyu Roh; 허훈

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자료유형: 학술저널

저자정보: Sang-Uk Han Bo Wang 손상용 Hojung Shin Chul Kyu Roh 허훈

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제19권 제4호

발행연도: 2019.1

수록면: 438 - 450 (13page)

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Purpose: Although linear-shaped gastroduodenostomy (LSGD) was reported to be a feasible and reliable method of Billroth I anastomosis in patients undergoing totally laparoscopic distal gastrectomy (TLDG), the feasibility of LSGD for patients undergoing totally robotic distal gastrectomy (TRDG) has not been determined. This study compared the feasibility of LSGD in patients undergoing TRDG and TLDG. Materials and Methods: All c: onsecutive patients who underwent LSGD after distal gastrectomy for gastric cancer between January 2009 and December 2017 were analyzed retrospectively. Propensity score matching (PSM) analysis was performed to reduce the selection bias between TRDG and TLDG. Short-term outcomes, functional outcomes, learning curve, and risk factors for postoperative complications were analyzed. Results: This analysis included 414 patients, of whom 275 underwent laparoscopy and 139 underwent robotic surgery. PSM analysis showed that operation time was significantly longer (163.5 vs. 132.1 minutes, P<0.001) and postoperative hospital stay significantly shorter (6.2 vs. 7.5 days, P<0.003) in patients who underwent TRDG than in patients who underwent TLDG. Operation time was the independent risk factor for LSGD after intracorporeal gastroduodenostomy. Cumulative sum analysis showed no definitive turning point in the TRDG learning curve. Long-term endoscopic findings revealed similar results in the two groups, but bile reflux at 5 years showed significantly better improvement in the TLDG group than in the TRDG group (P=0.016). Conclusions: LSGD is feasible in TRDG, with short-term and long-term outcomes comparable to that in TLDG. LSGD may be a good option for intracorporeal Billroth I anastomosis in patients undergoing TRDG.

참고문헌 (29)

참고문헌 신청

Hashizume M / 2002 / Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system / Surg Endosc 16:1187~1191

Alhossaini RM / 2017 / Robotic gastrectomy for gastric cancer: current evidence / Ann Gastroenterol Surg 1:82~89

Liu XX / 2013 / Full robot-assisted gastrectomy with intracorporeal robot-sewn anastomosis produces satisfying outcomes / World J Gastroenterol 19:6427~6437

Parisi A / 2015 / Robotic total gastrectomy with intracorporeal robot-sewn anastomosis: a novel approach adopting the double-loop reconstruction method / Medicine (Baltimore) 94:e1922

Ikeda O / 2009 / Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer / Surg Endosc 23:2374~2379

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