Uncut Roux-en-Y Reconstruction in a Laparoscopic Distal Gastrectomy: A Single-Center Study of 228 Consecutive Cases and Short-Term Outcomes

2019 ◽  
Vol 26 (6) ◽  
pp. 698-704 ◽  
Author(s):  
Li Yang ◽  
Hao Xu ◽  
Dian-Cai Zhang ◽  
Feng-Yuan Li ◽  
Wei-Zhi Wang ◽  
...  
Keyword(s):  
Distal Gastrectomy ◽  
Laparoscopic Distal Gastrectomy ◽  
Short Term ◽  
Conversion To Open Surgery ◽  
Operative Duration ◽  
Single Center Study ◽  
Distal Gastric Cancer ◽  
The Mean ◽  
Diet Intake ◽  
Mean Time

Aims. We have established a procedure for uncut Roux-en-Y gastrojejunostomy after laparoscopic distal gastrectomy. This study aimed to evaluate the safety and technical feasibility of the procedure for patients with distal gastric cancer according to the short-term outcomes. Methods. Two hundred and twenty-eight consecutive patients who underwent a laparoscopic distal gastrectomy with uncut Roux-en-Y gastrojejunostomy from September 2014 to August 2018 were reviewed retrospectively. All the laparoscopic operations were performed successfully without conversion to open surgery. Results. The mean operative duration was 178.28 ± 32.82 minutes, the mean anastomotic process duration was 28.22 ± 7.50 minutes, the average blood loss was 48.97 ± 29.16 mL, and the overall number of lymph nodes harvested was 37.16 ± 11.47. The mean time of out-of-bed ambulation, anal exsufflation, liquid-diet intake, and duration of hospital stay were 41.99 ± 18.37 hours, 69.57 ± 23.17 hours, 5.06 ± 1.09 days, and 8.77 ± 2.42 days, respectively. Fifteen patients suffered postoperative complications, and the overall incidence rate was 6.58% (15/228). Seventeen patients experienced afferent recanalization, the mean time of which was 11 months after the operation. Conclusion. The laparoscopic uncut Roux-en-Y reconstruction is safe and technically feasible, and it has inspiring short-term outcomes for patients undergoing distal gastrectomy.

Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

2021 ◽  
Author(s):  
Hai Thanh Phan
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Operative Time ◽  
Distal Gastrectomy ◽  
Three Dimensional ◽  
Oncologic Outcome ◽  
Intraoperative Blood Loss ◽  
3D Laparoscopy ◽  
Distal Gastric Cancer ◽  
The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

scholarly journals Short-Term Outcomes of Laparoscopic Distal Gastrectomy for Advanced Gastric Cancer

2016 ◽  
Vol 63 (1.2) ◽  
pp. 68-73 ◽  
Author(s):  
Masakazu Goto M.D. ◽  
Hiroshi Okitsu M.D., Ph.D ◽  
Yasuhiro Yuasa M.D., Ph.D ◽  
Shunsuke Kuramoto M.D. ◽  
Atsushi Tomibayashi M.D. ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Distal Gastrectomy ◽  
Laparoscopic Distal Gastrectomy ◽  
Short Term

scholarly journals Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: a single-institution prospective cohort study

2019 ◽  
Vol 6 (8) ◽  
pp. 2860
Author(s):  
Nguyen Thanh Xuan ◽  
Ho Huu Thien ◽  
Phan Hai Thanh ◽  
Pham Anh Vu ◽  
Nguyen Huu Son ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Operative Time ◽  
Bile Leakage ◽  
Short Term ◽  
Cyst Excision ◽  
Drain Removal ◽  
Laparoscopic Excision ◽  
The Mean ◽  
Mean Time ◽  
Time To Drain

Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases. 

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