Feasibility of augmented rectangle technique in laparoscopic distal gastrectomy: comparison with hemi-double stapling technique in a single-center retrospective cohort study

Successful Systemic Steroid Administration for the Treatment of Edematous Anastomotic Stenosis After the Laparoscopic Augmented Rectangle Technique for Billroth I Reconstruction for Laparoscopic Distal Gastrectomy

“…Billroth I anastomosis using the ART could create a wider anastomosis than the delta-shaped anastomosis [ 3 ]. However, Nishiguchi et al reported that the incidence of anastomotic stenosis using the ART method was 2.6% [ 4 ]. For our current case, although the cause of the edematous anastomotic stenosis was unknown, the inflammatory findings, elevated C-reactive protein levels, and white blood cell count suggested that the cause was ischemia or inflammation of the surrounding anastomosis.…”

“…Several intracorporeal anastomosis procedures, including delta-shaped anastomosis, [1] the triangulating stapling technique [2], and the augmented rectangle technique (ART), which was developed and reported by Fukunaga et al in 2018 [3], have been considered for laparoscopic distal gastrectomy. Despite these advancements, anastomotic stenosis is associated with a complication rate of 0% to 3.2% [2][3][4]. The treatment for anastomotic stenosis is endoscopic balloon dilatation or conservative waiting until natural recovery occurs, which are often ineffective; therefore, there is no established treatment for this condition.…”