J Gastric Cancer.  2012 Jun;12(2):120-125.

Comparative Study of Hand-Sutured versus Circular Stapled Anastomosis for Gastrojejunostomy in Laparoscopy Assisted Distal Gastrectomy

• Seo SH
• Kim KH
• Kim MC
• Choi HJ
• Jung GJ

Abstract

PURPOSE
Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer.
MATERIALS AND METHODS
Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups.
RESULTS
Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001).
CONCLUSIONS
Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.

Keyword

Laparoscopy; Gastric cancer; Billroth-II; Staple

MeSH Terms

Gastrectomy
Gastric Bypass
Hand
Humans
Laparoscopy
Stomach Neoplasms

Figure

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  Fig. 1 Simplified illustration of the hand-sutured anastomosis.

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  Fig. 2 Simplified illustration (A) and post-operative endoscopic finding (B) of the circular stapling anastomosis.

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