Total laparoscopic distal gastrectomy with Roux-en Y reconstruction.

Shim, Jung Ho; Kim, Jun Gi; Yoo, Han Mo; Oh, Seong Il; Jeon, Hae Myung; Park, Cho Hyun; Song, Kyo Young

PURPOSE The aim of this study was to introduce our technique and evaluate the technical efficacy of Roux-en Y (RY) reconstruction after total laparoscopic distal gastrectomy (TLDG). METHODS We performed TLDG using our own method of RY-type anastomosis in a total of 38 consecutive patients with gastric adenocarcinomas and evaluated the techniques and postoperative outcomes. RESULTS The mean operative time was 144.5 ± 22.4 minutes, including reconstruction time, which was 26.2 ± 3.5 minutes. Most patients were of pathologic stage IA (76.3%) or IB (10.5%), 3 patients were of stage II, and 2 were of stage IIIA. The length of postoperative hospital stay was 8.3 ± 3.3 days (range, 5 to 20 d). Two cases required reoperation because of internal herniation. According to our endoscopic observation, bile reflux into the gastric remnant stump was not found. CONCLUSIONS TLDG with RY reconstruction is technically feasible in gastric cancer patients.