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KMID : 0371420231050030172
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Annals of Surgical Treatment and Research
2023 Volume.105 No. 3 p.172 ~ p.177
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Intracorporeal modified delta-shaped gastroduodenostomy during 2-port distal gastrectomy: technical aspects and short-term outcomes
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Lee Se-Jin
Song Jeong-Ho
Park Sung-Hyun
Cho Min-Ah
Kim Yoo-Min
Hyung Woo-Jin
Kim Hyoung-Il
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Abstract
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Purpose : Surgeons have become increasingly interested in reduced-port gastrectomy to minimize trauma while maintaining oncologic safety. Although gastroduodenostomy has the benefits of better nutritional outcomes and fewer postoperative complications than other types of reconstruction, gastroduodenostomy is not a preferred option for reduced-port distal gastrectomy because of technical difficulties. In this study, we describe our intracorporeal modified delta-shaped gastroduodenostomy technique, which is easily applicable during 2-port distal gastrectomy.
Methods : We retrospectively reviewed our database of 30 consecutive patients with gastric cancer who underwent 2-port distal gastrectomy with intracorporeal modified delta-shaped gastroduodenostomy from October 2016 to May 2021. In this reduced-port approach, we used a Tropian Single port (TROPIAN TECH) via a 25-mm transumbilical incision and a 12-mm port at the right flank. All anastomoses were performed using a 60-mm endolinear stapler. We used 3 additional sutures to provide proper traction and support for the anastomosis.
Results : Mean ± standard deviation of operation time was 148.9 ± 34.7 minutes; reconstruction time was 13.2 ± 4.6 minutes; estimated blood loss was 29.3 ± 44.4 mL; and length of hospital stay was 4.5 ± 1.2 postoperative days. A total of 11 patients (36.7%) had a Clavien-Dindo grade I or grade II complication, and there were no grade IIIa or higher complications.
Conclusion : Intracorporeal modified delta-shaped gastroduodenostomy was safely performed via a 2-port approach, resulting in acceptable surgical outcomes and no major complications.
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KEYWORD
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Minimally invasive surgical procedures, Gastroenterostomy
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