J Gastric Cancer. 2017 Sep;17(3):255-266 https://doi.org/10.5230/jgc.2017.17.e32 pISSN 2093-582X·eISSN 2093-5641
Original Article
A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer Hoon Hur 1,*, Chang Wook Ahn2,*, Cheul Su Byun3, Ho Jung Shin Young Bae Kim4, Sang-Yong Son 1, Sang-Uk Han 1
,
1
Division of Gastrointestinal Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea Dr Ahn's Surgery Clinic, Yongin, Korea 3 Department of Surgery, Dongsuwon Hospital, Suwon, Korea 4 Department of Pathology, Ajou University School of Medicine, Suwon, Korea 1
2
Received: Jul 28, 2017 Revised: Sep 15, 2017 Accepted: Sep 18, 2017 Correspondence to Sang-Uk Han Division of Gastrointestinal Surgery, Department of Surgery, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea. Tel: +82-31-219-5200 Fax: +82-31-219-5756 E-mail: [email protected] *Hoon Hur and Chang Wook Ahn contributed equally to this work. Copyright © 2017. Korean Gastric Cancer Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ORCID iDs Hoon Hur https://orcid.org/0000-0002-5435-5363 Ho Jung Shin https://orcid.org/0000-0001-8938-5012 Sang-Yong Son https://orcid.org/0000-0002-8903-0913 Sang-Uk Han https://orcid.org/0000-0001-5615-4162
https://jgc-online.org
ABSTRACT 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
Original Article
A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer Hoon Hur 1,*, Chang Wook Ahn2,*, Cheul Su Byun3, Ho Jung Shin Young Bae Kim4, Sang-Yong Son 1, Sang-Uk Han 1
,
1
Division of Gastrointestinal Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea Dr Ahn's Surgery Clinic, Yongin, Korea 3 Department of Surgery, Dongsuwon Hospital, Suwon, Korea 4 Department of Pathology, Ajou University School of Medicine, Suwon, Korea 1
2
Received: Jul 28, 2017 Revised: Sep 15, 2017 Accepted: Sep 18, 2017 Correspondence to Sang-Uk Han Division of Gastrointestinal Surgery, Department of Surgery, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea. Tel: +82-31-219-5200 Fax: +82-31-219-5756 E-mail: [email protected] *Hoon Hur and Chang Wook Ahn contributed equally to this work. Copyright © 2017. Korean Gastric Cancer Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ORCID iDs Hoon Hur https://orcid.org/0000-0002-5435-5363 Ho Jung Shin https://orcid.org/0000-0001-8938-5012 Sang-Yong Son https://orcid.org/0000-0002-8903-0913 Sang-Uk Han https://orcid.org/0000-0001-5615-4162
https://jgc-online.org
ABSTRACT 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
