title: Sutureless jejuno-jejunal anastomosis in gastric cancer patients: a comparison with handsewn procedure in a single institute.
abstract: BACKGROUND
  The biofragmentable anastomotic ring has been used to this day for various types of anastomosis in the gastrointestinal tract, but it has not yet achieved widespread acceptance among surgeons. The purpose of this retrospective study is to compare surgical outcomes of sutureless with suture method of Roux-and-Y jejunojejunostomy in patients with gastric cancer.
  
  
  METHODS
  Two groups of patients were obtained based on anastomosis technique (sutureless group versus hand sewn group): perioperative outcomes were recorded for every patient.
  
  
  RESULTS
  The mean time spent to complete a sutureless anastomosis was 11 ± 4 min, whereas the time spent to perform hand sewn anastomosis was 23 ± 7 min. Estimated intraoperative blood loss was 178 ± 32 ml in the sutureless group and 182 ± 23 ml in the suture-method group with no significant differences. No complications were registered related to enteroanastomosis. Intraoperative mortality was none for both groups.
  
  
  CONCLUSIONS
  The Biofragmentable Anastomotic Ring offers a safe and time-saving method for the jejuno-jejunal anastomosis in gastric cancer surgery, and for this purpose the ring has been approved as a standard method in our clinic. Nevertheless currently there are few studies on upper gastrointestinal sutureless anastomoses and this could be the reason for the low uptake of this device.
authors.affiliation: Institution VIII General and Gastrointestinal Surgery, Chief Prof N Di Martino, School of Medicine, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy. marano.luigi@email.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.forename: Bartolomeo
authors.initials: B
authors.lastname: Braccio
authors.forename: Michele
authors.initials: M
authors.lastname: Schettino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Izzo
authors.forename: Angelo
authors.initials: A
authors.lastname: Cosenza
authors.forename: Michele
authors.initials: M
authors.lastname: Grassia
authors.forename: Raffaele
authors.initials: R
authors.lastname: Porfidia
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Reda
authors.forename: Marianna
authors.initials: M
authors.lastname: Petrillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Esposito
authors.forename: Natale
authors.initials: N
authors.lastname: Di Martino
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000295:instrumentation / Q000379:methods*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002276:Carcinoid Tumor / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008228:Lymphoma, Non-Hodgkin / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D053831:Surgical Fixation Devices; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000295:instrumentation*