A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer

허훈; 안창욱; 변철수; 신호정; 김영배; 손상용; 한상욱

doi:https://doi.org/10.5230/jgc.2017.17.e32

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자료유형: 학술저널

저자정보: 허훈 (아주대학교) 안창욱 (Dr Ahn's Surgery Clinic) 변철수 (동수원병원) 신호정 (아주대학교) 김영배 (아주대학교) 손상용 (아주대학교) 한상욱 (아주대학교)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제17권 제3호

발행연도: 2017.9

수록면: 255 - 266 (12page)

DOI: https://doi.org/10.5230/jgc.2017.17.e32

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Purpose: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. Materials and Methods: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. Results: No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026). Conclusions: The results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

#Gastric cancer #Distal gastrectomy #Roux en Y reconstruction #Circular stapler

참고문헌 (28)

참고문헌 신청

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