Reconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer

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dc.contributor.authorSchneider, Marcel Andre
dc.contributor.authorKim, Jeesun
dc.contributor.authorBerlth, Felix
dc.contributor.authorSugita, Yutaka
dc.contributor.authorGrimminger, Peter P.
dc.contributor.authorWijnhoven, Bas P. L.
dc.contributor.authorOvertoom, Hidde
dc.contributor.authorGockel, Ines
dc.contributor.authorThieme, Rene
dc.contributor.authorGriffiths, Ewen A.
dc.contributor.authorButterworth, William
dc.contributor.authorNienhuser, Henrik
dc.contributor.authorMueller, Beat
dc.contributor.authorCrnovrsanin, Nerma
dc.contributor.authorGero, Daniel
dc.contributor.authorNickel, Felix
dc.contributor.authorGisbertz, Suzanne
dc.contributor.authorvan Berge Henegouwen, Mark I.
dc.contributor.authorPucher, Philip H.
dc.contributor.authorKhan, Kashuf
dc.contributor.authorChaudry, Asif
dc.contributor.authorPatel, Pranav H.
dc.contributor.authorPera, Manuel
dc.contributor.authorDal Cero, Mariagiulia
dc.contributor.authorGarcia, Carlos
dc.contributor.authorMartinez Salinas, Guillermo
dc.contributor.authorKassab, Paulo
dc.contributor.authorPrado Castro, Osvaldo Antonio
dc.contributor.authorNorero, Enrique
dc.contributor.authorWisniowski, Paul
dc.contributor.authorPutnam, Luke Randall
dc.contributor.authorLombardi, Pietro Maria
dc.contributor.authorFerrari, Giovanni
dc.contributor.authorGudaityte, Rita
dc.contributor.authorMaleckas, Almantas
dc.contributor.authorProdehl, Leanne
dc.contributor.authorCastaldi, Antonio
dc.contributor.authorPrudhomme, Michel
dc.contributor.authorLee, Hyuk-Joon
dc.contributor.authorSano, Takeshi
dc.contributor.authorBaiocchi, Gian Luca
dc.contributor.authorDe Manzoni, Giovanni
dc.contributor.authorGiacopuzzi, Simone
dc.contributor.authorBencivenga, Maria
dc.contributor.authorRosati, Riccardo
dc.contributor.authorPuccetti, Francesco
dc.contributor.authorD'Ugo, Domenico
dc.contributor.authorNunobe, Souya
dc.contributor.authorYang, Han-Kwang
dc.contributor.authorGutschow, Christian Alexander
dc.date.accessioned2025-01-20T16:06:35Z
dc.date.available2025-01-20T16:06:35Z
dc.date.issued2024
dc.description.abstractObjective/Background:Various anastomotic and reconstruction techniques are used for minimally invasive total (miTG) and distal gastrectomy (miDG). Their effects on postoperative morbidity have not been extensively studied.Methods:MiTG and miDG patients were selected from 9356 oncological gastrectomies performed in 2017-2021 in 43 centers. Endpoints included anastomotic leakage (AL) rate and postoperative morbidity tested by multivariable analysis.Results:Three major anastomotic techniques [circular stapled (CS); linear stapled (LS); and hand sewn (HS)], and 3 major bowel reconstruction types [Roux (RX); Billroth I (BI); Billroth II (BII)] were identified in miTG (n=878) and miDG (n=3334). Postoperative complications, including AL (5.2% vs 1.1%), overall (28.7% vs 16.3%), and major morbidity (15.7% vs 8.2%), as well as 90-day mortality (1.6% vs 0.5%) were higher after miTG compared with miDG. After miTG, the AL rate was higher after CS (4.3%) and HS (7.9%) compared with LS (3.4%). Similarly, major complications (LS: 9.7%, CS: 16.2%, and HS: 12.7%) were lowest after LS. Multivariate analysis confirmed anastomotic technique as a predictive factor for AL, overall, and major complications. In miDG, AL rate (BI: 1.4%, BII 0.8%, and RX 1.2%), overall (BI: 14.5%, BII: 15.0%, and RX: 18.7%), and major morbidity (BI: 7.9%, BII: 9.1%, and RX: 7.2%), and mortality (BI: 0%, BII: 0.1%, and RY: 1.1%%) were not affected by bowel reconstruction.Conclusions:In oncologically suitable situations, miDG should be preferred to miTG, as postoperative morbidity is significantly lower. LS should be a preferred anastomotic technique for miTG in Western Centers. Conversely, bowel reconstruction in DG may be chosen according to the surgeon's preference.
dc.fuente.origenWOS
dc.identifier.doi10.1097/SLA.0000000000006470
dc.identifier.eissn1528-1140
dc.identifier.issn0003-4932
dc.identifier.urihttps://doi.org/10.1097/SLA.0000000000006470
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/89969
dc.identifier.wosidWOS:001328598200011
dc.issue.numero5
dc.language.isoen
dc.pagina.final798
dc.pagina.inicio788
dc.revistaAnnals of surgery
dc.rightsacceso restringido
dc.subjectanastomosis
dc.subjectcomplications
dc.subjectgastrectomy
dc.subjectgastric cancer
dc.subjectreconstruction
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleReconstruction Techniques and Associated Morbidity in Minimally Invasive Gastrectomy for Cancer
dc.typeartículo
dc.volumen280
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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