Abstract | BACKGROUND: This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. MATERIAL AND METHODS: The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. RESULTS: B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15.2 ± 10.5 days) than in B-I (12.8 ± 6.4 days; P = 0.034). The incidence of severe complications was higher in R-Y (13.7%) than in B-I (5.2%; P = 0.009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0.006). CONCLUSIONS: The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.
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Authors | Koshi Kumagai, Naoki Hiki, Souya Nunobe, Xiaohua Jiang, Takeshi Kubota, Susumu Aikou, Ryohei Watanabe, Shinya Tanimura, Takeshi Sano, Yuko Kitagawa, Toshiharu Yamaguchi |
Journal | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
(J Gastrointest Surg)
Vol. 15
Issue 12
Pg. 2145-52
(Dec 2011)
ISSN: 1873-4626 [Electronic] United States |
PMID | 21948148
(Publication Type: Evaluation Study, Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anastomosis, Roux-en-Y
(adverse effects)
- Female
- Gastrectomy
- Gastroenterostomy
(adverse effects)
- Humans
- Incidence
- Japan
- Laparoscopy
- Male
- Middle Aged
- Postoperative Complications
(etiology)
- Plastic Surgery Procedures
(adverse effects)
- Stomach Neoplasms
(pathology, surgery)
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