Yu Chao, Yang Tian, Yan Qiang, Li Deguan, Wang Yigao, Yang Xiaodong, Zhang Shangxin, Zhang Yonghong, Zhang Zhen
Department of General Surgery, Taizhou People's Hospital, Taizhou Medical College of Nanjing Medical University, Taizhou, China.
Anhui Medical University First Affiliated Hospital of General Surgery, 055162923887, 218 Jixi Road, Shushan District, Hefei City, Anhui Province, China.
Gastroenterol Res Pract. 2022 Apr 1;2022:9496271. doi: 10.1155/2022/9496271. eCollection 2022.
Uncut Roux-en-Y gastrojejunostomy, recently developed in China, is useful in the treatment of distal gastric cancer. This study is aimed at comparing laparoscopic gastric jejunum uncut Roux-en-Y anastomosis with conventional anastomosis in the surgical treatment of distal gastric malignancy.
In this retrospective study, the clinical data of 178 patients and their follow-up records were analyzed. 112 cases (uncut group) were the observation group for stomach jejunum uncut Roux-en-Y anastomosis, the control group for the stomach, 66 cases (conventional group) were for jejunum Roux-en-Y anastomosis and Billroth I and Billroth II anastomosis. A comparison between the two groups was conducted based on the general situation of the patients, TNM stage, and one-year survival rate.
There was no significant difference reported between the two groups in terms of the general situation and TNM stage. A comparison on postoperative complications between the two groups revealed that the postoperative bleeding was 0.9% and 6.1%, the bile reflux gastritis was 1.8% and 9.1%, the anastomotic leakage was 0.0% and 3.0%, the delayed gastric emptying was 0.9% and 7.6%, and the overall complications was at 3.6% and 25.8%, which was significantly lower in the observation group than in the control group, and the difference was statistically significant. Notably, there was no significant difference in 1-year survival rate between the two groups.
Laparoscopic gastric jejunal uncut Roux-en-Y anastomosis significantly reduces the risk of postoperative complications of the digestive tract. Its operation is easy and exhibits an effective curative effect.
未离断Roux-en-Y胃空肠吻合术是我国近年开展的术式，用于治疗远端胃癌。本研究旨在比较腹腔镜下未离断Roux-en-Y胃空肠吻合术与传统吻合术治疗远端胃癌的疗效。
回顾性分析178例患者的临床资料及随访记录。其中112例（未离断组）行未离断Roux-en-Y胃空肠吻合术为观察组，66例（传统组）行Roux-en-Y胃空肠吻合术及毕Ⅰ、毕Ⅱ式吻合术为对照组。比较两组患者的一般情况、TNM分期及1年生存率。
两组患者的一般情况及TNM分期差异无统计学意义。两组术后并发症比较，术后出血分别为0.9%和6.1%，胆汁反流性胃炎分别为1.8%和9.1%，吻合口漏分别为0.0%和3.0%，胃排空延迟分别为0.9%和7.6%，总并发症分别为3.6%和25.8%，观察组明显低于对照组，差异有统计学意义。两组1年生存率差异无统计学意义。
腹腔镜下未离断Roux-en-Y胃空肠吻合术可明显降低消化道术后并发症的发生风险，操作简便，疗效确切。
