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Evaluation of the delta-shaped anastomosis in laparoscopic distal gastrectomy: midterm results of a comparison with Roux-en-Y anastomosis

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Title: Evaluation of the delta-shaped anastomosis in laparoscopic distal gastrectomy: midterm results of a comparison with Roux-en-Y anastomosis
Authors: Kitagami, Hidehiko Browse this author
Morimoto, Mamoru Browse this author
Nozawa, Masashi Browse this author
Nakamura, Kenichi Browse this author
Tanimura, Shinya Browse this author
Murakawa, Katsuhiko Browse this author
Murakami, Yoshihiro Browse this author
Kikuchi, Kenji Browse this author
Ushigome, Hajime Browse this author
Sato, Leo Browse this author
Yamamoto, Minoru Browse this author
Shimizu, Yasunobu Browse this author
Hayakawa, Tetsushi Browse this author
Tanaka, Moritsugu Browse this author
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Delta-shaped anastomosis
Laparoscopic distal gastrectomy
Intracorporeal gastroduodenostomy
Billroth I reconstruction
Issue Date: Jul-2014
Publisher: Springer
Journal Title: Surgical Endoscopy and Other Interventional Techniques
Volume: 28
Issue: 7
Start Page: 2137
End Page: 2144
Publisher DOI: 10.1007/s00464-014-3445-6
PMID: 24515263
Abstract: Various methods of reconstruction after laparoscopic distal gastrectomy (LDG) have been developed and published, whereas only a limited number of reports are available on the utility of the delta-shaped anastomosis (Delta). This study compared Delta and Roux-en-Y anastomoses (RY), with the aim to clarify the utility of Delta. Stage 1 gastric cancer patients who had undergone LDG with Delta (group D, n = 68) and those who had undergone LDG with RY (group RY, n = 60) were compared in terms of operative outcomes, postoperative clinical symptoms, gastrointestinal fiberscopic findings, and changes in body weight. Both the operative and anastomotic times were significantly shorter in group D (230 and 13 min, respectively) than in group RY (258 and 38 min, respectively) (p < 0.001). Among the complications observed at the anastomotic site, obstruction was seen in one group D patient and two group RY patients but was relieved with conservative management. Postoperative clinical symptoms were reported for 26.4 % of the group D patients but had decreased to 5.9 % 1 year later. Group RY yielded similar results. Upper gastrointestinal fiberscopy performed 1 year postoperatively showed no intergroup differences in the incidence of gastritis or residual retention and a significantly more frequent occurrence of bile reflux in group D. Postoperative weight changes did not differ between the two groups. Delta reconstruction after LDG is a safe and effective procedure that is totally laparoscopic, less time consuming, and associated with a favorable postoperative course and a better quality of life.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 平野 聡

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