Billroth-I reconstruction using an overlap method in totally laparoscopic distal gastrectomy: propensity score matched cohort study of short- and long-term outcomes compared with Roux-en-Y reconstruction
| Autor: | Yusuke Mizuuchi, Masato Watanabe, Toru Nakano, Michiyo Saimura, Toshimitsu Iwashita, Kazuyoshi Nishihara, Yusuke Watanabe, Nobuhiro Suehara |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030230 surgery Anastomosis Patient Readmission Gastroduodenostomy Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Gastrectomy Stomach Neoplasms medicine Humans Billroth I Propensity Score Retrospective Studies business.industry Incidence Anastomosis Roux-en-Y Gallstones Middle Aged medicine.disease Roux-en-Y anastomosis Surgery Bowel obstruction Outcome and Process Assessment Health Care Propensity score matching Female Laparoscopy 030211 gastroenterology & hepatology Gastroenterostomy business Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 33:3990-4002 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | Delta-shaped anastomosis is an established procedure for intracorporeal Billroth-I reconstruction (B-I). However, this procedure has several technical and economic problems. The aim of the current study was to present the technique of B-I using an overlap method (overlap B-I), which is a side-to-side intracorporeal gastroduodenostomy in laparoscopic distal gastrectomy (LDG), and to evaluate the short- and long-term outcomes of this overlap B-I procedure. We retrospectively reviewed the medical records of 533 patients who underwent LDG with overlap B-I (n = 247) or Roux-en-Y reconstruction (R-Y) (n = 286). Patients with overlap B-I were propensity score matched to patients with R-Y in a 1:1 ratio. Short- and long-term outcomes of the two procedures were compared after matching. In the total cohort, anastomosis-related complications occurred in 2.4% of patients with overlap B-I, and 3.2% of those with R-Y (P = 0.794). Morbidity rate, including anastomosis-related complications, and postoperative course were comparable after overlap B-I performed by qualified versus general surgeons. Of 247 patients with overlap B-I, 169 could be matched. After matching, morbidity rate and postoperative course were comparable between the two procedures. Median operation time was significantly shorter for overlap B-I (205 min) than R-Y (252 min; P |
| Databáze: | OpenAIRE |
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