Comparisons Between Isoperistaltic and Antiperistaltic Gastrojejunostomy in Laparoscopic Distal Gastrectomy

Comparisons Between Isoperistaltic and Antiperistaltic Gastrojejunostomy in Laparoscopic Distal Gastrectomy, Randomized Prospective Pilot Study

Billroth-II (gastrojejunostomy) is one of major option after gastrectomy for gastric cancer. The investigators hypothesized that isoperistaltic anastomosis lead to higher incidence of dumping syndrome but antiperistaltic (anisoperistaltic) anastomosis have relevance to gastric stasis or obstruction. The investigators will assess complications, dumping syndrome and quality of life between isoperistaltic and antiperistaltic after distal gastrectomy for gastric cancer.

Recently, laparoscopic approach has been a option for gastric cancer, especially early gastric cancer. There are growing interest in quality of life in addition to recurrence or survival. There are few report about peristalsis and no report for quality of life according to a direction of peristalsis.

Inclusion Criteria:

• Histologically confirmed adenocarcinoma in stomach
• Scheduled as laparoscopic distal gastrectomy (tumor located lower or middle third)
• Planned with gastrojejunostomy after gastrectomy
• Clinical stage T1N0M0 or T2N0M0
• ECOG 0 or 1 (The Eastern Cooperative Oncology Group)
• ASA score class I-III (The American Society of Anesthesiologists)
• patient has given their written informed consent to participate in the study

Exclusion Criteria:

• Simultaneously combined resection of other organ (including cholecystectomy)
• Active other malignancy
• Requiring total gastrectomy
• Chronic inflammatory bowel disease or other chronic disease related to bowel motility
• Uncontrolled diabetes or patients with diabetic complications
• Vulnerable patients