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Efficacy of NiTi Hand CAC 30 for jejunojejunostomy in gastric cancer surgery: results from a multicenter prospective randomized trial.

 Hoon Hur  ;  Hyung Ho Kim  ;  Woo Jin Hyung  ;  Gyu Seok Cho  ;  Wook Kim  ;  Seung Wan Ryo  ;  Sang-Uk Han 
 GASTRIC CANCER, Vol.14(2) : 124-129, 2011 
Journal Title
Issue Date
Adenocarcinoma/surgery* ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y/adverse effects ; Anastomosis, Roux-en-Y/instrumentation* ; Anastomosis, Roux-en-Y/methods* ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Female ; Humans ; Jejunostomy* ; Jejunum/surgery* ; Male ; Middle Aged ; Stomach Neoplasms/surgery* ; Surgical Instruments/adverse effects
Roux-en-Y anastomosis ; Compression anastomosis clip ; Jejunojejunostomy ; Sutureless
BACKGROUND: Although a novel technique for the performance of intestinal sutureless anastomosis using a compression device has recently been investigated, it has not yet received widespread acceptance. We performed a multicenter prospective randomized trial in order to determine the clinical efficacy of the NiTi Hand CAC 30, a type of compression anastomosis clip (CAC), for jejunojejunostomy in gastric cancer surgery.

METHODS: Forty-seven patients from 6 institutions, who were diagnosed with gastric adenocarcinoma, were enrolled; these patients were randomized to a CAC group and a hand-sewn (control) group. Three patients dropped out for various reasons, and results for 44 patients were finally analyzed. The CAC group consisted of 20 patients, and there were 24 patients in the control group.

RESULTS: Anastomosis time, the primary endpoint of this trial, was shorter in the CAC group than in the control group (P < 0.001). However, total operation times (P = 0.055) did not differ. All reconstructions were completed by Roux-en-Y anastomosis, and the complication rates of the two groups did not differ (P = 0.908); however, jejunojejunostomy leakage occurred in two patients in the CAC group.

CONCLUSIONS: Our prospective multicenter clinical trial showed that the use of the NiTi Hand CAC™ 30 for jejunojejunostomy in gastric cancer surgery was feasible and could reduce anastomosis time. However, considering that there were two cases of leakage, extended use of the NiTi Hand CAC™ 30 should be carefully applied.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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