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Feasibility of Linear-Shaped Gastroduodenostomy during the Performance of Totally Robotic Distal Gastrectomy
Journal of Gastric Cancer ; : 438-450, 2019.
Article in English | WPRIM (Western Pacific) | ID: wpr-785958
Responsible library: WPRO
ABSTRACT

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.
Subject(s)

Full text: Available Database: WPRIM (Western Pacific) Main subject: Postoperative Complications / Stomach Neoplasms / Gastroenterostomy / Selection Bias / Retrospective Studies / Risk Factors / Laparoscopy / Bile Reflux / Propensity Score / Learning Curve Type of study: Etiology study / Observational study / Risk factors Limits: Humans Language: English Journal: Journal of Gastric Cancer Year: 2019 Document type: Article
Full text: Available Database: WPRIM (Western Pacific) Main subject: Postoperative Complications / Stomach Neoplasms / Gastroenterostomy / Selection Bias / Retrospective Studies / Risk Factors / Laparoscopy / Bile Reflux / Propensity Score / Learning Curve Type of study: Etiology study / Observational study / Risk factors Limits: Humans Language: English Journal: Journal of Gastric Cancer Year: 2019 Document type: Article
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