Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
-
J. Gastrointest. Surg. · Apr 2012
Predictive factors for anastomotic leakage after simultaneous resection of synchronous colorectal liver metastasis.
The optimal surgical strategy for resectable, synchronous, colorectal liver metastases remains unclear. The objective of this study was to determine which patients could benefit from staged resections instead of simultaneous resection by identifying predictive factors for postoperative morbidity and anastomotic leakage after simultaneous resection of synchronous, colorectal liver metastases and the primary colorectal tumor. ⋯ The frequency of morbidity and that of anastomotic leakage seemed to be high after simultaneous resection for synchronous colorectal liver metastases, especially when intraoperative blood loss or operation time increased greatly. Staged resections should be considered in cases in which excessive surgical stress from simultaneous resection of synchronous colorectal liver metastases would be expected.
-
J. Gastrointest. Surg. · Apr 2012
Totally laparoscopic Billroth II gastrectomy with a novel, safe, simple, and time-saving anastomosis by only stapling devices.
Totally laparoscopic gastrectomy represents the evolution of laparoscopy-assisted gastrectomy. Most surgeons prefer laparoscopy-assisted gastrectomy rather than totally laparoscopic procedures because of technical difficulties of intracorporeal anastomosis. We created one novel stapling anastomosis without hand-sewn technique in totally laparoscopic Billroth II gastrectomy. The feasibility and early surgical outcomes of totally laparoscopic Billroth II gastrectomy with stapling anastomosis and with hand-sewn anastomosis were introduced in this study. ⋯ We suggest that intracorporeal anastomosis using only stapling devices in the described method was as safe and feasible as by hand-sewn technique. Moreover, it is a simple and time-saving method without any difficult hand-sewn procedures.