A prospective randomized trial of hand-sutured versus mechanically stapled anastomoses for gastroduodenostomy after distal gastrectomy

Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703)

“…The primary endpoint in the present prospective study demonstrated that the proportion of patients who developed these two postoperative complications was lower than expected, compared with the proportions in these retrospective reports. In addition, the proportion of patients who developed these complications was considered to be equivalent to that of those who developed complications after ODG, where the proportion of patients who developed anastomotic leakage has been reported as 0.6%-2.7% and that of patients who developed pancreatic fi stula as 0.6% in Japan [12,19,20]. The overall proportion of in-hospital adverse events itself was 5.1%, which was also relatively [12,15].…”

Early postoperative anastomotic hemorrhage after gastrectomy for gastric cancer

“…Compared with leakage and stricture, anastomotic hemorrhage is rare and usually self-limited [1][2][3][4][5][6][7][8][9]. However, massive bleeding is lethal if not treated imme-…”

A novel modification of double stapling technique in Billroth I anastomosis

“…In addition, the opening is made on the opposite side of the tumor determining the proximal margin is easy, and cancer cell implantation through the circular stapler seems unlikely. Previous reports described the penetration site for the central rod of circular stapler as the corner of the stapler line at the greater curvature of the stomach [1,3,4]. As a necessity, the circular and linear stapler lines cross each other.…”

“…The hemi-double stapling technique, which was introduced in 1995 [1] and its modification were reported in 2004 and 2007 [2][3][4], has been used as a safe procedure in bowel anastomosis. At our institute, the modified double-stapling end-toend gastroduodenostomy technique has been used for several years.…”