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Comparing the short-term outcomes of totally intracorporeal gastroduodenostomy with extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer: a single surgeon’s experience and a rapid systematic review with meta-analysis

Authors
 Deok Gie Kim  ;  Yoon Young Choi  ;  Ji Yeong An  ;  In Gyu Kwon  ;  In Cho  ;  Yoo Min Kim  ;  Jung Min Bae  ;  Myung Gyu Song  ;  Sung Hoon Noh 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.27(9) : 3153-3161, 2013 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2013
MeSH
Blood Loss, Surgical/statistics & numerical data ; C-Reactive Protein/analysis ; Diet ; Duodenum/surgery* ; Female ; Gastroenterostomy/methods* ; Humans ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Operative Time ; Pain Management ; Retrospective Studies ; Stomach Neoplasms/surgery* ; Treatment Outcome
Keywords
Intracorporeal gastroduodenostomy ; Extracorporeal gastroduodenostomy ; Laparoscopic distal gastrectomy ; Gastric cancer
Abstract
BACKGROUND: Since delta-shaped gastroduodenostomy was introduced, many surgeons have utilized laparoscopic distal gastrectomy (LDG) with totally intracorporeal Billroth I (ICBI) for gastric cancer, because it is expected to have several advantages over laparoscopic-assisted distal gastrectomy with extracorporeal Billroth I (ECBI). In this study, we compared these two reconstruction options to evaluate their outcomes. METHODS: The data of 166 gastric cancer patients who underwent LDG performed by a single surgeon between April 2009 and February 2012 were analyzed retrospectively. The subjects were divided into ECBI (n = 106) and ICBI (n = 60) groups, and then the clinical characteristics, surgical outcomes, symptoms, and change in BMI at 3 months after surgery were compared. Furthermore, a rapid systematic review and meta-analysis were conducted. RESULTS: The operative time was significantly shorter in the ICBI group (197.4 ± 45.5 vs. 157.1 ± 43.9 min), but blood loss was similar between the groups. Regarding surgical outcomes, there were no significant differences in the length of hospital stay, soft diet initiation, visual analogue scale, frequency of analgesics injection, and postoperative white blood cell counts and C-reactive protein levels between the groups. The surgical complication rates were 5.7 and 13.3% in the ECBI and ICBI groups, respectively, and one case of anastomosis leakage was observed in each group. At 3 months after surgery, reflux symptoms were more frequent in the ICBI group, but other gastrointestinal symptoms and the change of BMI were similar between the groups. The meta-analysis revealed no significant differences in the operative time, time to first flatus, length of hospital stay, frequency of analgesic usages, and rates of anastomosis complications between the groups. CONCLUSIONS: We could not demonstrate the clinical superiority of ICBI over ECBI based on our data and a rapid systematic review and meta-analysis. The anastomosis method may be selected according to patient conditions and the surgeon's preference.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-013-2869-8
DOI
10.1007/s00464-013-2869-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, In Gyu(권인규) ORCID logo https://orcid.org/0000-0002-1489-467X
Kim, Yoo Min(김유민)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Bae, Jung Min(배정민)
Cho, In(조인)
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87672
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