Comparison of the efficacy of modified Billroth Ⅱ versus traditional Billroth Ⅱ anastomosis in laparoscopic distal gastrectomy based on propensity score matching analysis
JIANG Ming-rui
ZHOU Jia-jie
SUN Long-he
JI Jin
SHAN Hai
WANG Wei
REN Jun
TANG Dong
WANG Liu-hua
WANG Dao-rong
Abstract：Objective To analyze the clinical effects of using modified Billroth Ⅱ anastomosis(R-method anastomosis)and traditional Billroth Ⅱ anastomosis to complete gastrointestinal reconstruction in laparoscopic distal gastrectomy for gastric cancer.Methods A retrospective analysis was conducted using propensity score matching on the clinical and pathological data from 445 patients diagnosed with gastric cancer who underwent laparoscopic distal gastrectomy at Subei People's Hospital in Jiangsu Province from July 2020 to March 2023.Patients were divided into two groups based on the gastrojejunostomy anastomosis method.Among them,115 patients underwent R-method gastrojejunostomy(R group)while 330 patients underwent the traditional method(traditional group).The traditional group was further categorized into simple BillrothⅡ anastomosis(B2 subgroup with 116 patients)and Billroth Ⅱ+Braun anastomosis(B+B subgroup with 114 patients).Surgical-related indicators and incidence of complications were compared between these groups.Results All patients successfully received the surgery.The anastomosis time of the R group(31.3±4.4)min was shorter than that of the traditional group(33.9±5.5)min,B2 subgroup(34.6±5.1)min,and B+B subgroup(33.3±5.8)min,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in intraoperative bleeding,number of lymph node dissections,postoperative exhaust time,gastric tube retention time,inflow food time,and postoperative hospitalization time(P＞0.05).In terms of postoperative complications,no anastomotic stenosis occurred in the R group,while 7 cases(7.3％)occurred in the traditional group,with a statistically significant difference(P＜0.05).Only one case of gastric paralysis(grade A)occurred in the R group after surgery while 11 cases(grade A 8 cases,grade B 3 cases)occurred in the traditional group,with statistically significant differences in incidence(x2=8.889,P=0.003)and severity(x2=10.912,P=0.004).Conclusion The R-method gastrojejunostomy,when employed in laparoscopic distal gastrectomy for gastric cancer based on Billroth Ⅱ anastomosis,effectively reduces anastomosis time and decreases the occurrence of postoperative anastomotic stenosis and gastric emptying dysfunction,worth wide clinical application in this context.
Keywords：laparoscopydistal gastrectomyBillroth Ⅱ anastomosisanastomosis timeanastomosis stenosis
Publication Date：2024-10-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1149-1154 )