title: Comparison of stricture rates using three different gastrojejunostomy anastomotic techniques in laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  No single gastrojejunostomy anastomosis technique (GJA) in Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently preferred over another. Bendewald et al. confirmed that there was no difference in anastomotic stricture rates when comparing hand-sewn (HS), linear-stapled (LS), and circular-stapled (CS) GJA techniques. We present and analyze our own institutional data to readdress stricture rates.
  
  
  METHODS
  From January 2010 to January 2013, 860 consecutive patients underwent LRYGB using HS, LS, and CS anastomotic techniques at a single institution. All patients in this study were followed to see if they had a complication of a stricture within this time period. Hospital records were retrospectively reviewed and those who had stricture complications shown on endoscopy requiring intervention were compiled and compared using univariate analysis.
  
  
  RESULTS
  Patient demographics did not differ substantially between the three groups. The most common technique employed was LS (n = 429, 49.8%), followed by CS (n = 254, 29.5%) and HS (n = 177, 20.6%), respectively. Using multivariate analysis, there was a significant difference in the rate of strictures between the anastomotic techniques (LS 4.42%, HS 2.82%, CS 1.18%, p = 0.0163).
  
  
  CONCLUSIONS
  Our data show that the discussion of which anastomotic technique is superior should be reopened given the statistically significant low rate of strictures in patients who underwent LRYGB with a CS anastomosis in comparison with LS and HS anastomoses.
authors.affiliation: Montefiore Medical Center, New York, USA, azamali@gmail.com.
authors.forename: Azam
authors.initials: A
authors.lastname: Qureshi
authors.forename: Dina
authors.initials: D
authors.lastname: Podolsky
authors.forename: Lindsay
authors.initials: L
authors.lastname: Cumella
authors.forename: Mujahid
authors.initials: M
authors.lastname: Abbas
authors.forename: Jenny
authors.initials: J
authors.lastname: Choi
authors.forename: Pratibha
authors.initials: P
authors.lastname: Vemulapalli
authors.forename: Diego
authors.initials: D
authors.lastname: Camacho
mesh_terms: D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000209:etiology; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects*