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

Surg Innov. 2019 Dec;26(6):698-704. doi: 10.1177/1553350619860964. Epub 2019 Jul 13.

Abstract

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.

Keywords: gastric cancer; laparoscopic gastrectomy; outcomes; uncut Roux-en-Y anastomosis.

MeSH terms

  • Aged
  • Anastomosis, Roux-en-Y* / adverse effects
  • Anastomosis, Roux-en-Y* / methods
  • Anastomosis, Roux-en-Y* / statistics & numerical data
  • Blood Loss, Surgical / statistics & numerical data
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Gastrectomy* / statistics & numerical data
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Laparoscopy* / statistics & numerical data
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Stomach / surgery
  • Stomach Neoplasms / surgery
  • Treatment Outcome