title: Antecolic reconstruction is a predictor of the occurrence of roux stasis syndrome after distal gastrectomy.
abstract: BACKGROUND
  Roux-en-Y reconstruction after distal gastrectomy can result in delayed gastric emptying, called Roux stasis syndrome (RSS). The cause of RSS has not been completely identified. This study retrospectively investigated the development of RSS.
  
  
  METHODS
  Between April 2008 and March 2014, we performed 138 procedures with distal gastrectomy using Roux-en-Y reconstruction. The development of RSS was analyzed and examined for correlations with the length of the operation, amount of blood loss, and surgical procedure.
  
  
  RESULTS
  RSS was observed in 16 of the 138 patients. There were no relationships between the length of the operation or amount of blood loss and the development of RSS according to the Mann-Whitney U test. There were also no significant differences in the development of RSS between the patients treated with laparotomy and laparoscopic surgery, end-to-side, side-to-side, or end-to-end anastomosis or isoperistaltic or antiperistaltic anastomosis, as determined using the chi-square test. However, the development of RSS tended to lower in the patients who underwent laparoscopic surgery, side-to-side anastomosis, and isoperistaltic anastomosis. In addition, there was a significant difference between the patients who received antecolic and retrocolic reconstruction (p=0.005).
  
  
  CONCLUSIONS
  Our findings suggest that antecolic reconstruction correlates with a lower likelihood of developing RSS.
authors.affiliation: Department of Surgery, Funabashi Municipal Medical Center, 1-21-1, Kanasugi, Funabashi-shi, Chiba, 273-8588, Japan, antique_ryo2@hotmail.com.
authors.forename: Ryota
authors.initials: R
authors.lastname: Otsuka
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Natsume
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Hajime
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuzaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*