Cargando…

Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis

Background: Delayed gastric emptying (DGE) is a major complication of pancreatoduodenectomy (PD). Several efforts have been made to decrease the incidence of DGE. However, the optimal anastomotic method for gastro/duodenojejunostomy (GJ) remains debatable. Moreover, few studies have reported the imp...

Descripción completa

Detalles Bibliográficos
Autores principales: Takagi, Kosei, Umeda, Yuzo, Yoshida, Ryuichi, Fuji, Tomokazu, Yasui, Kazuya, Kimura, Jiro, Hata, Nanako, Yagi, Takahito, Fujiwara, Toshiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863298/
https://www.ncbi.nlm.nih.gov/pubmed/36675661
http://dx.doi.org/10.3390/jcm12020732
_version_ 1784875299164389376
author Takagi, Kosei
Umeda, Yuzo
Yoshida, Ryuichi
Fuji, Tomokazu
Yasui, Kazuya
Kimura, Jiro
Hata, Nanako
Yagi, Takahito
Fujiwara, Toshiyoshi
author_facet Takagi, Kosei
Umeda, Yuzo
Yoshida, Ryuichi
Fuji, Tomokazu
Yasui, Kazuya
Kimura, Jiro
Hata, Nanako
Yagi, Takahito
Fujiwara, Toshiyoshi
author_sort Takagi, Kosei
collection PubMed
description Background: Delayed gastric emptying (DGE) is a major complication of pancreatoduodenectomy (PD). Several efforts have been made to decrease the incidence of DGE. However, the optimal anastomotic method for gastro/duodenojejunostomy (GJ) remains debatable. Moreover, few studies have reported the impact of GJ surgical techniques on outcomes following robotic pancreatoduodenectomy (RPD). This study aimed to investigate the surgical outcomes of robot-sewn and stapled GJ anastomoses in RPD. Methods: Forty patients who underwent RPD at the Okayama University Hospital between September 2020 and October 2022 were included. The outcomes between robot-sewn and stapled anastomoses were compared. Results: The mean [standard deviation (SD)] operative and GJ time were 428 (63.5) and 34.0 (15.0) minutes, respectively. Postoperative outcomes included an overall incidence of DGE of 15.0%, and the mean postoperative hospital stays were 11.6 (5.3) days in length. The stapled group (n = 21) had significantly shorter GJ time than the robot-sewn group (n = 19) (22.7 min versus 46.5 min, p < 0.001). Moreover, stapled GJ cases were significantly associated with a lower incidence of DGE (0% versus 21%, p = 0.01). Although not significant, the stapled group tended to have shorter postoperative hospital stays (9.9 days versus 13.5 days, p = 0.08). Conclusions: Our findings suggest that stapled GJ anastomosis might decrease anastomotic GJ time and incidence of DGE after RPD. Surgeons should select a suitable method for GJ anastomosis based on their experiences with RPD.
format Online
Article
Text
id pubmed-9863298
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-98632982023-01-22 Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis Takagi, Kosei Umeda, Yuzo Yoshida, Ryuichi Fuji, Tomokazu Yasui, Kazuya Kimura, Jiro Hata, Nanako Yagi, Takahito Fujiwara, Toshiyoshi J Clin Med Technical Note Background: Delayed gastric emptying (DGE) is a major complication of pancreatoduodenectomy (PD). Several efforts have been made to decrease the incidence of DGE. However, the optimal anastomotic method for gastro/duodenojejunostomy (GJ) remains debatable. Moreover, few studies have reported the impact of GJ surgical techniques on outcomes following robotic pancreatoduodenectomy (RPD). This study aimed to investigate the surgical outcomes of robot-sewn and stapled GJ anastomoses in RPD. Methods: Forty patients who underwent RPD at the Okayama University Hospital between September 2020 and October 2022 were included. The outcomes between robot-sewn and stapled anastomoses were compared. Results: The mean [standard deviation (SD)] operative and GJ time were 428 (63.5) and 34.0 (15.0) minutes, respectively. Postoperative outcomes included an overall incidence of DGE of 15.0%, and the mean postoperative hospital stays were 11.6 (5.3) days in length. The stapled group (n = 21) had significantly shorter GJ time than the robot-sewn group (n = 19) (22.7 min versus 46.5 min, p < 0.001). Moreover, stapled GJ cases were significantly associated with a lower incidence of DGE (0% versus 21%, p = 0.01). Although not significant, the stapled group tended to have shorter postoperative hospital stays (9.9 days versus 13.5 days, p = 0.08). Conclusions: Our findings suggest that stapled GJ anastomosis might decrease anastomotic GJ time and incidence of DGE after RPD. Surgeons should select a suitable method for GJ anastomosis based on their experiences with RPD. MDPI 2023-01-16 /pmc/articles/PMC9863298/ /pubmed/36675661 http://dx.doi.org/10.3390/jcm12020732 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Technical Note
Takagi, Kosei
Umeda, Yuzo
Yoshida, Ryuichi
Fuji, Tomokazu
Yasui, Kazuya
Kimura, Jiro
Hata, Nanako
Yagi, Takahito
Fujiwara, Toshiyoshi
Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title_full Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title_fullStr Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title_full_unstemmed Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title_short Surgical Techniques of Gastrojejunostomy in Robotic Pancreatoduodenectomy: Robot-Sewn versus Stapled Gastrojejunostomy Anastomosis
title_sort surgical techniques of gastrojejunostomy in robotic pancreatoduodenectomy: robot-sewn versus stapled gastrojejunostomy anastomosis
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863298/
https://www.ncbi.nlm.nih.gov/pubmed/36675661
http://dx.doi.org/10.3390/jcm12020732
work_keys_str_mv AT takagikosei surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT umedayuzo surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT yoshidaryuichi surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT fujitomokazu surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT yasuikazuya surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT kimurajiro surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT hatananako surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT yagitakahito surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis
AT fujiwaratoshiyoshi surgicaltechniquesofgastrojejunostomyinroboticpancreatoduodenectomyrobotsewnversusstapledgastrojejunostomyanastomosis