title: Totally laparoscopic Roux-en-Y gastrojejunostomy after laparoscopic distal gastrectomy: analysis of initial 50 consecutive cases of single surgeon in comparison with totally laparoscopic Billroth I reconstruction.
abstract: OBJECTIVE
  Roux-en-Y reconstruction (RY) in laparoscopic distal gastrectomy for gastric cancer is a more complicated procedure than Billroth-I (BI) or Billroth-II. Here, we offer a totally laparoscopic simple RY using linear staplers.
  
  
  METHODS
  Each 50 consecutive patients with totally laparoscopic distal gastrectomy with RY and BI were enrolled in this study. Technical safety and surgical outcomes of RY were evaluated in comparison with BI.
  
  
  RESULTS
  In all patients, RY gastrectomy using linear staplers was safely performed without any events during surgery. The mean operation time and anastomosis time were 177.0±37.6 min and 14.4±5.6 min for RY, respectively, which were significantly longer than those for BI (150.4±34.0 min and 5.9±2.2 min, respectively). There were no differences in amount of blood loss, time to flatus passage, diet start, length of hospital stay, and postoperative inflammatory response between the two groups. Although there was no significant difference in surgical complications between RY and BI (6.0% and 14.0%), the RY group showed no anastomosis site-related complications.
  
  
  CONCLUSIONS
  The double stapling method using linear staplers in totally laparoscopic RY reconstruction is a simple and safe procedure.
authors: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. ugids@naver.com.
authors: Ji Yeong
authors: JY
authors: An
authors: In
authors: I
authors: Cho
authors: Yoon Young
authors: YY
authors: Choi
authors: Yoo Min
authors: YM
authors: Kim
authors: Sung Hoon
authors: SH
authors: Noh
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery
keywords: Intracorporeal Roux-en-Y gastrojejunostomy; intracorporeal Billroth-I reconstruction; surgical outcome; technical safety; totally laparoscopic distal gastrectomy