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Ohmura et al. Mini-invasive Surg 2019;3:4 I http://dx.doi.org/10.20517/2574-1225.2018.69 Page 9 of 13

A Length of the grater curvature
(mm)
290
r = 0.45, P < 0.01
270
250
230
210
190
170
150
15 20 25 30 35
BMI (kg/m )
2
B Length of the grater curvature
(mm)
290 r = 0.07, P = 0.47

270
250
230
210
190
170
150
15 20 25 30 35
2
BMI (kg/m )
Figure 5. Simple linear regression analyses between BMI and the length of the greater curvature of resected stomach. The length of the
greater curvature weakly correlated with BMI in the extracorporeal total hand-sewn group (A); while there was no correlation between
BMI and length of the greater curvature in the intracorporeal hemi-hand-sewn group (B)

Table 2. Size of resected specimen
EC-THS (n = 85) IC-HHS (n = 110) P value
Maximum tumor, mean ± SD (mm) 31.6 ± 15.5 35.6 ± 28.1 P = 0.20
Greater curvature, mean ± SD (mm) 214.6 ± 21.7 228.7 ± 19.7 P < 0.01
Lesser curvature, mean ± SD (mm) 148.7 ± 17.6 149.2 ± 18.3 P = 0.50
Duodenum, mean ± SD (mm) 14.7 ± 3.6 14.1 ± 4.0 P = 0.22
Proximal margin, mean ± SD (mm) 53.4 ± 32.4 54.1 ± 32.5 P = 0.88
Distal margin, mean ± SD (mm) 77.1 ± 35.7 78.5 ± 39.8 P = 0.87
SD: standard deviation; EC-THS: extracorporeal-total hand-sewn group; IC-HHS: intracorporeal-hemi-hand-sewn group

other hand, intracorporeal B-I reconstruction by means of open surgery requires considerable advanced
technical skill. Therefore, several procedures for B-I intracorporeal gastroduodenostomies specific to
[16]
laparoscopic surgery have been reported, such as IC-DS gastroduodenostomy , triangulation stapling
[22]
[25]
technique , book binding technique [23,24] , overlap method , and double-stapling technique with circular
stapler. Sufficient blood supply of digestive tracts, absence of excessive tension, well-apposed tissues at the
anastomotic site, and appropriate anastomotic techniques are critically important factors for successful and
safe anastomosis. In terms of blood supply and tension between the reconstructing digestive tract, hemi-
[26]
double stapling technique with circular stapler is the best procedure for gastroduodenostomy . However,