A novel modification of double stapling technique in Billroth I anastomosis

An, Ji Yeong; Yoon, Seok Ho; Pak, Kyung Ho; Heo, Geon-Ung; Oh, Sung Jin; Hyung, Woo Jin; Noh, Sung Hoon

doi:10.1002/jso.21368

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…In surgical procedure of subtotal gastrectomy, surgeons transect the distal stomach that is to be resected and complete the gastrojejunostomy with the linear stapler. After performing anastomosis by using stapler, suture line with stapling material is usually located in the lesser curvature side of the remnant stomach and around gastrojejunostomy site [ 12 , 13 ]. Therefore, performing ESD for the remnant stomach lesion around these sites is frequently technically demanding.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy

et al. 2016

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Background/Aims:Endoscopic submucosal dissection (ESD) for tumors occurring in the remnant stomach is technically difficult to perform because of limited working space and severe fibrosis and staples present around the suture line. We aimed to elucidate the feasibility and clinical outcomes of performing ESD for tumors in the remnant stomach.Methods:Between December 2007 and January 2013, 18 patients underwent ESD for tumors (six adenomas and 12 differentiated-type early gastric cancers [EGCs]) occurring in the remnant stomach after distal gastrectomy. Clinicopathologic features and clinical outcomes after ESD were retrospectively analyzed.Results:Two-thirds of the lesions were located on the body, and half were located on the suture line. En bloc resection, R0 resection, and en bloc with R0 resection rates were 88.9%, 100%, and 88.9%, respectively. Curative resection rate for EGC was 91.7%. Perforation occurred in one patient (5.6%) and was successfully managed by endoscopic closure with metallic clips and conservative management. There was no significant bleeding after ESD. During a median follow-up of 47.5 months, no local, metachronous, or extragastric recurrence was seen for either EGC or adenoma lesions.Conclusions:ESD is a feasible and effective treatment modality and can be considered a primary intervention for early gastric neoplasia occurring in the remnant stomach.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy

et al. 2016

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“…Previous studies have reported manipulation of the stomach without prior resection of the mass containing portion of the distal stomach. 3,4 However, our technique allows us to confirm complete resection of the tumor as well as tumor-free margins by freezing the section prior to proceeding with the anastomosis. (2) By using the 25-mm circular stapler, the likelihood of traumatic injury to the jejunum would be less.…”

Section: Discussionmentioning

confidence: 99%

Stapling Technique for Performing Billroth II Anastomosis After Distal Gastrectomy

Hong

et al. 2011

Journal of Gastrointestinal Surgery

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The circular stapling technique has been widely applied for gastrointestinal anastomosis in gastrectomies (open or laparoscopic) for distal gastric cancers. We describe this method for use in performing Billroth II anastomosis in distal gastrectomies. From 2002-2009, we report the results following the use of the circular stapling technique performed in 520 patients at a single institution. The median time of completing the anastomosis was shorter using the stapling technique compared to the hand-sewn technique. The use of the stapler resulted in two cases of minor intraluminal bleeding at the anastomotic site. The circular stapling method can be applied safely and more efficiently in performing Billroth II reconstruction after distal gastrectomy compared to the hand-sewn method in patients with gastric cancer.

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“…Subsequent studies including a randomized controlled trial supported his results,2324 and spleen preservation is now a standard procedure for total gastrectomy. He also developed new surgical techniques that can reduce anastomosis leakage after gastroduodenostomy 2526…”

Section: Development and Standardization Of Surgical Techniques For Gmentioning

confidence: 99%

Ten Thousand Consecutive Gastrectomies for Gastric Cancer: Perspectives of a Master Surgeon

et al. 2019

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As radical gastrectomy with lymph node dissection is currently the best strategy to cure gastric cancer, the role of the surgeon remains quite important in conquering it. Dr. Sung Hoon Noh, a surgeon and surgical oncologist specializing in gastric cancer, has treated gastric cancer for 30 years and has conducted over 10000 cases of gastrectomy for gastric cancer. He first adapted an electrocautery device into gastric cancer surgery and has led standardization of surgical procedures, including spleen preserving gastrectomy. His procedures based on patient-oriented insights have become the basis of the concept of enhanced recovery after surgery. He has also contributed to improving patient's survival through adoption of a multidisciplinary approach: he proved the benefit of adjuvant chemotherapy after radical D2 gastrectomy for stage II/III gastric cancer in clinical trials, updating treatment guidelines throughout the world. Dr. Noh also opened the era of precision medicine for treating gastric cancer, as he developed and validated a mRNA expression based algorithm to predict prognosis and response to chemotherapy. This article reviews his contribution and long history of service in the field of gastric cancer. The perspectives of this master surgeon, based on his profound experience and insights, will outline directions for integrative multidisciplinary health care and how can surgeons prepare for the future.

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A novel modification of double stapling technique in Billroth I anastomosis

Cited by 7 publications

References 3 publications

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy

Stapling Technique for Performing Billroth II Anastomosis After Distal Gastrectomy

Ten Thousand Consecutive Gastrectomies for Gastric Cancer: Perspectives of a Master Surgeon

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