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The technical outcomes of delta-shaped anastomosis in laparoscopic distal gastrectomy: a single-center safety and feasibility study

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Abstract

Background

The indications for laparoscopic gastrectomy for early stomach cancer have spread worldwide, and the short-term outcomes have been favorable. Intraabdominal delta-shaped gastroduodenostomy using endoscopic linear staplers, a technique which was developed by Kanaya et al. is one of the feasible reconstructive procedures. Pure laparoscopic surgery is reported to be associated with several intraoperative and postoperative advantages in comparison with laparoscopy-assisted surgery. However, the clinical results remain uncertain. The present study aimed to evaluate both the technical feasibility and safety of delta-shaped anastomosis with LDG according to the short-term outcomes.

Methods

The study group was composed of 229 patients who underwent delta-shaped anastomosis with LDG at Gifu University School of Medicine from December 2004 to December 2014.

Results

The median total operative blood loss and operative time were 20 ml and 277 min, respectively. Postoperative complications were detected in 20 (8.7 %) patients. The complications included: anastomotic stenosis, n = 3 (1.3 %); anastomotic leakage, n = 3 (1.3 %); pancreatic injury, n = 8 (3.5 %); anastomotic ulcer, n = 1 (0.4 %); bowel obstruction, n = 1 (0.4 %); abdominal abscess, n = 1 (0.4 %); lymphorrhea, n = 1 (0.4 %); cardiac failure, n = 1 (0.4 %); and infection, n = 1 (0.4 %). The complications were classified as grade 2, n = 4 (1.7 %); grade 3a, n = 12 (5.2 %); grade 3b, n = 4 (1.7 %); and grade 4 and 5, n = 0 (0 %).

Conclusion

The findings of the present study indicate the safety of Kanaya’s procedure and that it should provide better outcomes in patients who undergo intracorporeal gastroduodenostomy after laparoscopic distal gastrectomy.

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Authors and Affiliations

  1. Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan

    Nobuhisa Matsuhashi, Kazuya Yamaguchi, Naoki Okumura, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Takao Takahashi, Shinji Osada & Kazuhiro Yoshida

Authors
  1. Nobuhisa Matsuhashi
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  2. Kazuya Yamaguchi
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  3. Naoki Okumura
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  4. Toshiyuki Tanahashi
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  5. Satoshi Matsui
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  6. Hisashi Imai
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  7. Yoshihiro Tanaka
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  8. Takao Takahashi
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  9. Shinji Osada
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  10. Kazuhiro Yoshida
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Corresponding author

Correspondence to Kazuhiro Yoshida.

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Disclosures

K. Yoshida has received honoraria for lecture from Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Eli Lilly and Company, Daiichi Sankyo Co., Ltd., Ono Pharmaceutical Co., Ltd., Merck Serono Co., Ltd., Novartis Pharma K.K., Sanofi K.K., and research funding from Ajinomoto Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ono Pharmaceutical Co., Yakult Honsha Co., Ltd., outside the submitted work. All remaining authors declare that they have no conflict of interest.

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Matsuhashi, N., Yamaguchi, K., Okumura, N. et al. The technical outcomes of delta-shaped anastomosis in laparoscopic distal gastrectomy: a single-center safety and feasibility study. Surg Endosc 31, 1257–1263 (2017). https://doi.org/10.1007/s00464-016-5103-7

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  • DOI: https://doi.org/10.1007/s00464-016-5103-7

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