Comparative analysis of two digestive tract reconstruction methods in total laparoscopic radical total gastrectomy  

作　　者：Tian-Xiang Dong Dong Wang Qun Zhao Zhi-Dong Zhang Xue-Feng Zhao Bi-Bo Tan Yu Liu Qing-Wei Liu Pei-Gang Yang Ping-An Ding Tao Zheng Yong Li Zi-Jing Liu 

机构地区：[1]Third Department of Surgery of the Fourth Hospital of Hebei Medical University,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer,Shijiazhuang 050011,Hebei Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第4期1109-1120,共12页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by 2024 Government-funded Clinical Medicine Talent Project,No.ZF2024122.

摘　　要：BACKGROUND The incidence of gastric cancer has significantly increased in recent years.Surgical resection is the main treatment,but the method of digestive tract reconstruction after gastric cancer surgery remains controversial.In the current study,we sought to explore a reasonable method of digestive tract reconstruction and improve the quality of life and nutritional status of patients after surgery.To this end,we statistically analyzed the clinical results of patients with gastric cancer who underwent jejunal interposition double-tract reconstruction(DTR)and esophageal jejunum Roux-en-Y reconstruction(RY).AIM To explore the application effect of DTR in total laparoscopic radical total gastrectomy(TLTG)and evaluate its safety and efficacy.METHODS We collected the relevant data of 77 patients who underwent TLTG at the Fourth Hospital of Hebei Medical University from October 2021 to January 2023.Among them,35 cases were treated with DTR,and the remaining 42 cases were treated with traditional RY.After 1:1 propensity score matching,the cases were grouped into 31 cases per group,with evenly distributed data.The clinical characteristics and short-and long-term clinical outcomes of the two groups were statistically analyzed.RESULTS The two groups showed no significant differences in basic data,intraoperative blood loss,number of lymph node dissections,first defecation time after operation,postoperative hospital stay,postoperative complications,and laboratory examination results on the 1st,3rd,and 5th days after operation.The operation time of the DTR group was longer than that of the RY group[(307.58±65.14)min vs(272.45±62.09)min,P=0.016],but the first intake of liquid food in the DTR group was shorter than that in the RY group[(4.45±1.18)d vs(6.0±5.18)d,P=0.028].The incidence of reflux heartburn(Visick grade)and postoperative gallbladder disease in the DTR group was lower than that in the RY group(P=0.033 and P=0.038).Although there was no significant difference in body weight,hemoglobin,prealbumin,and albumin b

关 键 词：Gastric cancer Jejunal interposition double-tract reconstruction Roux-en-Y reconstruction LAPAROSCOPE 

分 类 号：R735.2[医药卫生—肿瘤]