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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.6
- 수록면
- 46 - 51 (6page)
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초록· 키워드
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Purpose: Totally laparoscopic distal gastrectomy (TLDG) is now widely used for early gastric cancer patients, but the selection of a reconstruction method after TLDG is still controversial. Roux-en-Y gastrojejunostomy is increasingly used in expectation of less gastritis and alkaline reflux despite its technical difficulty. The uncut Roux-en-Y gastrojejunostomy (uRYGJ) retains the advantages of Roux-en-Y reconstruction but helps prevent Roux stasis syndrome. The present study aims to introduce a single surgeon’s experience of TLDG with uRYGJ and analyze the learning curve and surgical outcomes.
Methods: We retrospectively reviewed the medical records of 124 consecutive patients who underwent TLDG with uRYGJ performed by a single surgeon between July 2014 and August 2015 at Asan Medical Center. The baseline characteristics and surgical outcomes were analyzed, and the learning curve was drawn based on the power-law model.
Results: The mean total operative time was 165 minutes, and the average length of hospital stay was 6.6 days. Complications included two cases of duodenal stump leakage, two intra-abdominal bleeding, two intra-abdominal fluid collection, one wound problem, two anastomotic strictures, 14 ileus, and no anastomotic leakage. There were five cases of endoscopically proven reflux gastritis/esophagitis and no Roux stasis syndrome. There were five recurrences and one mortality during the follow-up period. The learning curve leveled at the 15th case.
Conclusion: The results of our study showed the safety and feasibility of uRYGJ, and that the technical difficulty of the procedure can be overcome with a short learning curve for experienced surgeons.
Methods: We retrospectively reviewed the medical records of 124 consecutive patients who underwent TLDG with uRYGJ performed by a single surgeon between July 2014 and August 2015 at Asan Medical Center. The baseline characteristics and surgical outcomes were analyzed, and the learning curve was drawn based on the power-law model.
Results: The mean total operative time was 165 minutes, and the average length of hospital stay was 6.6 days. Complications included two cases of duodenal stump leakage, two intra-abdominal bleeding, two intra-abdominal fluid collection, one wound problem, two anastomotic strictures, 14 ileus, and no anastomotic leakage. There were five cases of endoscopically proven reflux gastritis/esophagitis and no Roux stasis syndrome. There were five recurrences and one mortality during the follow-up period. The learning curve leveled at the 15th case.
Conclusion: The results of our study showed the safety and feasibility of uRYGJ, and that the technical difficulty of the procedure can be overcome with a short learning curve for experienced surgeons.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Lamb P / 2008 / Gastric cancer surgery : a balance of risk and radicality / Ann R Coll Surg Engl 90:235~242
Kim HH / 2010 / Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer : an interim report : a phase III multicenter, prospective, randomized Trial(KLASS Trial) / Ann Surg 251:417~420
김창현 / 2015 / JaA Comparison of Outcomes of Three Reconstruction Methods after Laparoscopic Distal Gastrectomy / Journal of Gastric Cancer 15(1):46~52
Katai H / 2008 / Reconstruction after distal gastrectomy / Nihon Geka Gakkai Zasshi 109:264~268
엄방울 / 2016 / Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014 / Journal of Gastric Cancer 16(3):131~140
Kim HH / 2010 / Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer : an interim report : a phase III multicenter, prospective, randomized Trial(KLASS Trial) / Ann Surg 251:417~420
김창현 / 2015 / JaA Comparison of Outcomes of Three Reconstruction Methods after Laparoscopic Distal Gastrectomy / Journal of Gastric Cancer 15(1):46~52
Katai H / 2008 / Reconstruction after distal gastrectomy / Nihon Geka Gakkai Zasshi 109:264~268
엄방울 / 2016 / Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014 / Journal of Gastric Cancer 16(3):131~140
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UCI(KEPA) : I410-ECN-0101-2020-514-000882458