Examination of Total Gastrectomiy-Reconstruction Using

Abstract

Reconstructive operation using instrumental anastomosis was performed on 44 of 101 cases of total gastgrectomy experienced during a period of recent 5 years up to Feburary 1989, and was compared with the contemporaneous hand-suture reconstruction mainly for operative contents, postoperative complications and the like. In the instrumental anastomosis group, some shortening of the reconstructive time was obtained not only by p-Roux-Y method using 2 EEAs and Roux-Y method as standard reconstruction, but also by a use of purse-string instrument (PSI) and TA55 for purse-sting suture nd for stiump closure, respectively. The instrumental anasotmosis group showed major and minor incomplete suture in 1 case, each, totalling 2 (4.5%) and stenosis in 3(6.8%), compared with major and minor incomplete suture in 2 and 3, respectively, totalling 5(8.8%) and no case of stenosis in the hand-suture group. Incomplete suture and stenosis more often occurred forthe latter and former groups, respectively. Postoperative hospitalization averaged to count 32.7 and 39.4 days, respectively, being shorter for the former group. Rate of dissected n3 and that of concomitantly-resected pancreatocaudal, spleen were 36% and 21%, and 66% and 42%, respectively. Thoracotomy was performed in 25% of the cases. Obviously, the instrumental anastomosis group more often received enlargement operaiton.