Reconstruction techniques and associated morbidity in minimally invasive gastrectomy for cancer: Insights from the GastroBenchmark and GASTRODATA databases
Mostra el registre complet Registre parcial de l'ítem
- dc.contributor.author Schneider, Marcel André
- dc.contributor.author Garcia, Carlos
- dc.contributor.author Martinez Salinas, Guillermo
- dc.contributor.author GASTRODATA consortium
- dc.date.accessioned 2025-02-19T07:22:42Z
- dc.date.available 2025-02-19T07:22:42Z
- dc.date.issued 2024
- dc.description.abstract Objective/background: Various anastomotic and reconstruction techniques are used for minimally invasive total (miTG) and distal gastrectomy (miDG). Their effects on postoperative morbidity have not been extensively studied. Methods: MiTG and miDG patients were selected from 9356 oncological gastrectomies performed in 2017-2021 in 43 centers. Endpoints included anastomotic leakage (AL) rate and postoperative morbidity tested by multivariable analysis. Results: Three major anastomotic techniques [circular stapled (CS); linear stapled (LS); and hand sewn (HS)], and 3 major bowel reconstruction types [Roux (RX); Billroth I (BI); Billroth II (BII)] were identified in miTG (n=878) and miDG (n=3334). Postoperative complications, including AL (5.2% vs 1.1%), overall (28.7% vs 16.3%), and major morbidity (15.7% vs 8.2%), as well as 90-day mortality (1.6% vs 0.5%) were higher after miTG compared with miDG. After miTG, the AL rate was higher after CS (4.3%) and HS (7.9%) compared with LS (3.4%). Similarly, major complications (LS: 9.7%, CS: 16.2%, and HS: 12.7%) were lowest after LS. Multivariate analysis confirmed anastomotic technique as a predictive factor for AL, overall, and major complications. In miDG, AL rate (BI: 1.4%, BII 0.8%, and RX 1.2%), overall (BI: 14.5%, BII: 15.0%, and RX: 18.7%), and major morbidity (BI: 7.9%, BII: 9.1%, and RX: 7.2%), and mortality (BI: 0%, BII: 0.1%, and RY: 1.1%%) were not affected by bowel reconstruction. Conclusions: In oncologically suitable situations, miDG should be preferred to miTG, as postoperative morbidity is significantly lower. LS should be a preferred anastomotic technique for miTG in Western Centers. Conversely, bowel reconstruction in DG may be chosen according to the surgeon's preference.
- dc.format.mimetype application/pdf
- dc.identifier.citation Schneider MA, Kim J, Berlth F, Sugita Y, Grimminger PP, Wijnhoven BPL, et al. Reconstruction techniques and associated morbidity in minimally invasive gastrectomy for cancer: Insights from the GastroBenchmark and GASTRODATA databases. Ann Surg. 2024 Nov 1;280(5):788-98. DOI: 10.1097/SLA.0000000000006470
- dc.identifier.doi http://dx.doi.org/10.1097/SLA.0000000000006470
- dc.identifier.issn 0003-4932
- dc.identifier.uri http://hdl.handle.net/10230/69633
- dc.language.iso eng
- dc.publisher Lippincott Williams & Wilkins
- dc.relation.ispartof Ann Surg. 2024 Nov 1;280(5):788-98
- dc.rights © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
- dc.subject.keyword Anastomosis
- dc.subject.keyword Complications
- dc.subject.keyword Gastrectomy
- dc.subject.keyword Gastric cancer
- dc.subject.keyword Reconstruction
- dc.title Reconstruction techniques and associated morbidity in minimally invasive gastrectomy for cancer: Insights from the GastroBenchmark and GASTRODATA databases
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion