Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2014 Jan;55(1):162-9. doi: 10.3349/ymj.2014.55.1.162.
Roux-en-Y reconstruction (RY) in laparoscopic distal gastrectomy for gastric cancer is a more complicated procedure than Billroth-I (BI) or Billroth-II. Here, we offer a totally laparoscopic simple RY using linear staplers.
Each 50 consecutive patients with totally laparoscopic distal gastrectomy with RY and BI were enrolled in this study. Technical safety and surgical outcomes of RY were evaluated in comparison with BI.
In all patients, RY gastrectomy using linear staplers was safely performed without any events during surgery. The mean operation time and anastomosis time were 177.0±37.6 min and 14.4±5.6 min for RY, respectively, which were significantly longer than those for BI (150.4±34.0 min and 5.9±2.2 min, respectively). There were no differences in amount of blood loss, time to flatus passage, diet start, length of hospital stay, and postoperative inflammatory response between the two groups. Although there was no significant difference in surgical complications between RY and BI (6.0% and 14.0%), the RY group showed no anastomosis site-related complications.
The double stapling method using linear staplers in totally laparoscopic RY reconstruction is a simple and safe procedure.
腹腔镜远端胃癌根治术中 Roux-en-Y（RY）重建比 Billroth-I（BI）或 Billroth-II 更复杂。在此，我们提供一种完全腹腔镜下使用线性吻合器的简单 RY 重建方法。
本研究纳入了 50 例连续接受完全腹腔镜远端胃癌根治术和 BI 及 RY 的患者。比较了 RY 与 BI 的技术安全性和手术结果。
所有患者均成功完成了使用线性吻合器的 RY 胃切除术，术中无任何事件发生。RY 组的平均手术时间和吻合时间分别为 177.0±37.6 分钟和 14.4±5.6 分钟，明显长于 BI 组（150.4±34.0 分钟和 5.9±2.2 分钟）。两组间出血量、肛门排气时间、开始进食时间、住院时间和术后炎症反应无差异。虽然 RY 和 BI 两组的手术并发症无显著差异（6.0%和 14.0%），但 RY 组无吻合口相关并发症。
完全腹腔镜下使用线性吻合器的双吻合器法 RY 重建是一种简单、安全的方法。
