徳島大学 教育・研究者情報データベース(EDB)

1. 吉川 幸造

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2. 島田 光生([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.消化器・移植外科学])

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3. 徳永 卓哉([徳島大学.病院.中央診療施設等.地域外科診療部])

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4. 中尾 寿宏

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5. 西 正暁([徳島大学.大学院医歯薬学研究部.医学域.連携研究部門(医学域).寄附講座系(医学域).実践地域診療・医科学])

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6. 髙須 千絵([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.消化器・移植外科学])

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7. 柏原 秀也([徳島大学.病院.先端医科医療開発研究プロジェクト]/[徳島大学.病院.診療科.外科.消化器・移植外科])

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8. 和田 佑馬([徳島大学.病院.診療科.外科.消化器・移植外科])

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9. 良元 俊昭([徳島大学.病院.栄養部])

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(英) Stapler insertion angle toward the esophagus reduces the incidence of early postoperative Roux stasis syndrome after distal gastrectomy in minimally invasive surgery.

(英) Roux stasis syndrome (RSS) after Roux-en-Y (RY) reconstruction significantly prolongs the hospital stay and decreases the quality of life. The purpose of the present study was to evaluate the incidence of RSS in patients who underwent distal gastrectomy for gastric cancer and to identify the factors related to the development of RSS after mechanical RY reconstruction in minimally invasive surgery (MIS). This study included 134 patients who underwent distal gastrectomy in MIS with mechanical RY anastomosis. RSS was defined as the presence of symptoms such as nausea, vomiting, or abdominal fullness, and the confirmation of delayed gastric emptying on imaging or gastrointestinal fiber testing. Clinical data were checked, including body mass index, operative procedure, age, sex, operative time, blood loss volume, extent of lymph node dissection, final stage, stapler insertion angle, method of entry hole closure. The relationship between the incidence of RSS and these factors was analyzed. RSS occurred in 24 of 134 patients (17.9%). RSS occurred significantly more frequently in patients with D2 lymphadenectomy than in patients with D1 + lymphadenectomy (p = 0.04). All patients underwent side-to-side anastomosis via the antecolic route. The incidence of RSS was significantly greater in patients with a stapler insertion angle toward the greater curvature (n = 20, 22.5%) versus the esophagus (n = 4, 8.9%) (p = 0.04). The multivariate logistic regression model revealed that the stapler insertion angle to the greater curvature is identified as independent risk factor for RSS (OR 3.23, 95%Cl 1.01-10.3, p = 0.04). Stapler insertion angle toward the esophagus may reduce the incidence of early postoperative RSS rather than toward the greater curvature.

1. (英) Humans
2. (英) Incidence
3. (英) Quality of Life
4. (英) Gastrectomy
5. (英) Anastomosis, Roux-en-Y
6. (英) Esophagus
7. (英) Stomach Neoplasms
8. (英) Minimally Invasive Surgical Procedures
9. (英) Postoperative Complications

1. (英) Article.ELocationID: 54

2. (英) Article.ELocationID: 10.1186/s12893-023-01954-3

3. (英) Article.PublicationTypeList.PublicationType: Journal Article

4. (英) KeywordList.Keyword: Distal gastrectomy

5. (英) KeywordList.Keyword: Rous stasis syndrome

6. (英) KeywordList.Keyword: Stapler insertion angle

7. (英) CoiStatement: The authors declare no competing interests.