Comparison of Uncut Roux-en-Y and Billroth Ⅱ + Braun anastomosis in laparoscopic distal gastrectomy for gastric cancer
LU Kangpeng
WANG Liuhua
WANG Daorong
QIAN Jing
Abstract：Objective To compare the efficacy of laparoscopic gastric jejunum Uncut Roux-en-Y anastomosis with Billroth Ⅱ +Braun anastomosis in the surgical treatment of distal gastric cancer.Methods The data of 102 patients undergoing laparoscopic radical gastrectomy for distal gastric cancer from January 2020 to April 2022 in the Gastrointestinal Center of Northern Jiangsu People's Hospital were retrospectively analyzed.Of them,42 patients underwent Uncut Roux-en-Y anastomosis and were assigned to the URY group,and 60 patients underwent Billroth Ⅱ +Braun anastomosis and were assigned to the B 2 B group.The general data,perioperative indicators,postoperative complications,nutritional status,and gastroscopy 1 year after surgery were compared between the two groups.And the quality of life of the two groups was evaluated using QLQ-STO22 scale at 1 year after surgery.Results Laparoscopic radical GC resection was successfully performed in both groups,without conversion to laparotomy and perioperative death.There were no significant differences in operation time,anastomosis time,intraoperative blood loss,first postoperative exhaust time,liquid feeding time,drainage tube removal time and postoperative hospitalization time between the two groups(P>0.05).There were no significant differences in postoperative anastomotic fistula,duodenal stump fistula,intestinal obstruction and incision infection between the two groups(P>0.05).During 1-year follow-up,1 patient in the URY group developed liver metastasis,and 2 patients in the B2 B group had tumor recurrence,of whom 1 patient had liver metastasis and 1 patient with extensive abdominal metastasis died.One year after surgery,91 cases completed gastroscopy,including 37 cases in URY group and 54 cases in B2 B group.There were 5 cases(13.5％)of gastric retention in URY group and 18 cases(33.3％)in B2 B group,the difference was statistically significant(χ2 =4.567,P =0.033).For bile reflux,there were 3 cases(8.1％)and 16 cases(29.6％)in two groups,respectively,and the difference was statistically significant(χ2 =6.156,P =0.013).There were 1 case(2.7％)and 12 cases(22.2％)of reflux gastritis in two groups,respectively,and the difference was statistically significant(χ2 =6.832,P =0.009).There was no significant difference in reflux esophagitis between the two groups with 1 case(2.7％)and 3 cases(5.6％),respectively(χ2 =0.017,P =0.895).The nutritional status of the two groups was assessed 1 year after surgery,and no significant differences in hemoglobin,serum albumin,total protein,blood lymphocyte count and PNI between the two groups(P>0.05)were observed.One year after surgery,64 cases completed QLQ-STO22 questionnaire survey,with 28 cases in URY group and 36 cases in B2 B group.The score showed that compared with B 2 B group,reflux score was reduced in URY group,and the difference was statistically significant(P<0.05).Conclusion Uncut Roux-en-Y anastomosis procedure is an ideal reconstruction of the digestive tract in patients with gastric cancer after laparoscopic radical distal gastrectomy,reducing gastric retention,bile reflux and reflux gastritis,and improving the quality of life of patients after surgery.
Keywords：laparoscopydistal gastric cancerdigestive tract reconstructiongastrojejunostomy
Publication Date：2024-02-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 25-31 )