For reconstruction after distal gastrectomy, the Roux-en-Y gastrojejunostomy is superior to the Billroth II gastrojejunostomy in terms of bile reflux. Roux-en-Y gastrojejunostomy prevents reflux gastritis, esophagitis, and carcinogenesis of the gastric remnant. However, the Roux-en-Y gastrojejunostomy is relatively complicated and lengthy. The authors perform a simple, safe Roux-en-Y gastrojejunostomy using modified hemi-double stapling. We applied this technique to 42 patients with gastric cancer. The average operating and reconstruction times were 172.6 ± 42.0 and 26.2 ± 4.8 min, respectively. The postoperative courses were uneventful and the patients were discharged 11.2 ± 2.4 days postoperatively. Neither leakage nor bleeding from the gastrojejunostomy has occurred postoperatively. The postoperative follow-up was 7–24 months and no local recurrence or stricture at the gastrojejunostomy site occurred. Roux-en-Y gastrojejunostomy using the modified hemi-double stapling technique can achieve reconstruction more simply, safely and quickly, and may provide an alternative reconstruction method for distal gastrectomy.

The antiperistaltic ileostomy is effective in reducing the daily amount of ileostomy effluent and facilitates stoma care, owing to its diminished liquid component.

Purpose: Stage-related treatment has been recommended for gallbladder cancer (GBC). When patients with T2 tumors undergo an extended cholecystectomy, the 5˗year survival rates have been reported to be 64∼100%. But when patients with T2 tumors undergo simple cholecystectomy, the 5˗year survival rates have been reported to be only 20∼40%. The question may rise as to which patients benefit from simple cholecystectomy among patients with T2 GBC. We investigated the survivals and the facts leading to death or recurrence after simple cholecystectomy for T2 GBC. Methods: Between Mar. 2001 and Dec. 2007, 13 patients had refused second radical operation for T2 GBC incidentally discovered after simple cholecystectomy. Survival analyses were evaluated by clinopathological factors. Results: The 1˗, 3˗ and 4˗year overall survival rates were 84.6%, 76.2% and 38.1% and 1˗ and 3˗year disease-free survival rates were 69.2%, 51.3%. The factors affected survival rates were low serum albumin titer and R1 resection (Lymph node metastasis or cystic duct involvement in microscopic finding) (P＜0.05). Conclusion: Simple cholecystectomy is not a curative method of T2 GBC, because it reveals lower 5˗year survival rates compared to those of extended cholecystectomy or radical surgery. But in the case when the patient refuses reoperation or it is difficult to undergo reoperation because of severe underlying disease, simple cholecystectomy with normal albumin titer or the absence of lymph node metastasis and absence of cystic duct involvement in microscopic findings may help the long-term survivals after simple cholecystectomy.

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Purpose:The final aim of operation for anorectal malformations (ARMs) is acquisition of normal bowel habit by preserving an anorectal function. This study was performed to assess the functional results after definite correction of the malformations.