BACKGROUND/AIMS: The factors influencing the development of small intestinal obstruction following gastric surgery are controversial. METHODOLOGY: Univariate and multivariate analyses were carried out on data from 48 patients with gastric cancer who underwent total gastrectomy and Roux-en-Y reconstruction for a potential cure. RESULTS: Of these 48 patients, 11 (22.9%) presented with mechanical obstruction in the small intestine postoperatively. There were no statistically significant differences with regard to age, sex, and the presenting pathology. The development of obstruction was not related to a longer operation time, a greater estimated blood loss during surgery, an extensive lymph node dissection and a combined resection of adjacent organs. The probability that the antecolic anastomosis would cause obstruction was significant when compared with findings in case of the retrocolic anastomosis (P < 0.05). In the multivariate logistic regression analysis, the significant risk factors related to the development of small intestinal obstruction proved to be reconstructive route of jejunal loop. CONCLUSIONS: In potentially curative patients undergoing total gastrectomy, retrocolic anastomosis should be attempted to prevent the development of postoperative intestinal obstruction.
BACKGROUND/AIMS: The factors influencing the development of small intestinal obstruction following gastric surgery are controversial. METHODOLOGY: Univariate and multivariate analyses were carried out on data from 48 patients with gastric cancer who underwent total gastrectomy and Roux-en-Y reconstruction for a potential cure. RESULTS: Of these 48 patients, 11 (22.9%) presented with mechanical obstruction in the small intestine postoperatively. There were no statistically significant differences with regard to age, sex, and the presenting pathology. The development of obstruction was not related to a longer operation time, a greater estimated blood loss during surgery, an extensive lymph node dissection and a combined resection of adjacent organs. The probability that the antecolic anastomosis would cause obstruction was significant when compared with findings in case of the retrocolic anastomosis (P < 0.05). In the multivariate logistic regression analysis, the significant risk factors related to the development of small intestinal obstruction proved to be reconstructive route of jejunal loop. CONCLUSIONS: In potentially curative patients undergoing total gastrectomy, retrocolic anastomosis should be attempted to prevent the development of postoperative intestinal obstruction.
Authors: Sung Geun Kim; Kyo Young Song; Han Hong Lee; Eun Young Kim; Jun Hyun Lee; Hae Myung Jeon; Kyung Hwa Jeon; Hyung Min Jin; Dong Jin Kim; Wook Kim; Han Mo Yoo; Jeong Gu Kim; Cho Hyun Park Journal: Medicine (Baltimore) Date: 2019-05 Impact factor: 1.817