Short-Term Outcomes of Intracorporeal Delta-Shaped Gastroduodenostomy Versus Extracorporeal Gastroduodenostomy after Laparoscopic Distal Gastrectomy for Gastric Cancer

김유나; 안지영; 최윤영; 최민규; 이준호; 손태성; 배재문; 김성

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자료유형: 학술저널

저자정보: 김유나 안지영 최윤영 최민규 이준호 손태성 배재문 김성

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제19권 제1호

발행연도: 2019.1

수록면: 111 - 120 (10page)

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연구방법

🏆

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Background: Billroth I anastomosis is one of the most common reconstruction methods after distal gastrectomy for gastric cancer. Intracorporeal Billroth I (ICBI) anastomosis and extracorporeal Billroth I (ECBI) anastomosis are widely used in laparoscopic surgery. Here we compared ICBI and ECBI outcomes at a major gastric cancer center. Methods: We retrospectively analyzed data from 2,284 gastric cancer patients who underwent laparoscopic distal gastrectomy between 2009 and 2017. We divided the subjects into ECBI (n=1,681) and ICBI (n=603) groups, compared the patients’ clinical characteristics and surgical and short-term outcomes, and performed risk factor analyses of postoperative complication development. Results: The ICBI group experienced shorter operation times, less blood loss, and shorter hospital stays than the ECBI group. There were no clinically significant intergroup differences in diet initiation. Changes in white blood cell counts and C-reactive protein levels were similar between groups. Grade II–IV surgical complication rates were 2.7% and 4.0% in the ECBI and ICBI groups, respectively, with no significant intergroup differences. Male sex and a body mass index (BMI) ≥30 were independent risk factors for surgical complication development. In the ECBI group, patients with a BMI ≥30 experienced a significantly higher surgical complication rate than those with a lower BMI, while no such difference was observed in the ICBI group. Conclusion: The surgical safety of ICBI was similar to that of ECBI. Although the chosen anastomotic technique was not a risk factor for surgical complications, ECBI was more vulnerable to surgical complications than ICBI in patients with a high BMI (≥30).

참고문헌 (22)

참고문헌 신청

양한광 / 2004 / 전국 위암 환자 진료 현황에 관한 설문조사 결과 / Journal of Gastric Cancer 4(2):95~108

Kim BJ / 1999 / Gastroduodenostomy after gastric resection for cancer / Am Surg 65:905~907

Kumagai K / 2012 / Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan / Surg Today 42:411~418

Lee JH / 2013 / Method of reconstruction governs iron metabolism after gastrectomy for patients with gastric cancer / Ann Surg 258:964~969

Song KY / 2008 / Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study / J Gastrointest Surg 12:1015~1021

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