Delta‐shaped anastomosis in totally robotic Billroth I gastrectomy: technical aspects and short‐term outcomes. Issue 4 (26th April 2016)

• Record Type: Journal Article
• Authors: Kikuchi, Kenji; Suda, Koichi; Nakauchi, Masaya; Shibasaki, Susumu; Nakamura, Kenichi; Kajiwara, Shuhei; Goto, Ai; Inaba, Kazuki; Ishida, Yoshinori; Uyama, Ichiro
• Is Part Of: Asian journal of endoscopic surgery. Volume 9:Issue 4(2016:Nov.)
• Page Start: 250
• Page End: 257
• Publication Date: 2016-04-26
• Subjects: Billroth‐I reconstruction -- delta‐shaped anastomosis -- robotic gastrectomy; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12288
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: Introduction: Delta‐shaped anastomosis has been recognized as a method of intracorporeal Billroth I anastomosis in totally laparoscopic distal gastrectomy. However, the technical aspects and outcomes of the delta‐shaped anastomosis in totally robotic distal gastrectomy have never been reported. Methods: A single‐institutional, non‐randomized, retrospective study was performed between 2009 and 2013. During the study period, 47 patients underwent robotic distal gastrectomy followed by robotic delta‐shaped Billroth I reconstruction, and 165 patients underwent conventional laparoscopic distal gastrectomy followed by laparoscopic delta‐shaped Billroth I reconstruction. After 64 were excluded because of insufficient intraoperative video, 43 patients in the robotic group and 105 patients in the laparoscopic group were enrolled in the study. Short‐term outcomes were determined from medical records and full‐length operative videos. Results: There were no significant differences between the robotic and laparoscopic groups in terms of morbidity (4.7% vs 3.8%), anastomosis‐related complications (0% vs 1.0%), non‐anastomosis‐related complications (2.3% vs 0%), or systemic complications (2.3% vs 0%). Time for reconstruction did not vary between the robotic group (16.6 min [8.8–42.9 min]) and the laparoscopic group (15.8 min [7.2–41.0 min]). There was no mortality in this series. In the conventional group, the morbidity rate was 3.8%. The anastomosis‐related complication rate was 1.0% in the conventional group. Conclusions: Given the excellent short‐term outcomes related to anastomosis, delta‐shaped anastomosis after robotic distal gastrectomy was at least as feasible and safe as delta‐shaped anastomosis after laparoscopic distal gastrectomy.