Abstract：【Objective】To explore the therapeutic efficacy and impact on the quality of life of laparoscopic non-disruptive Roux-en-Y distal anastomosis for radical gastrectomy in treating patients with T14aN03M0 gastric cancer. 【Methods】Eighty patients with T1-4aN0-3M0 gastric cancer were divided into the non-disruptive group (43 patients) and the traditional group (37 patients) based on the surgical approach. The non-disruptive group underwent laparoscopic non-disruptive Roux-en-Y distal anastomosis for radical gastrectomy, while the traditional group underwent traditional laparoscopic Roux-en-Y distal anastomosis for radical gastrectomy. The surgical indicators, pre- and post-operative gastric fluid pH values, self-rated quality of life scores, and incidence of complications were compared between the two groups. 【Results】There was no significant difference in postoperative hospital stay, time to postoperative anal exhaust, preoperative gastric fluid pH value, and time to liquid food intake after surgery, postoperative day 1 gastric fluid pH value, and total complication rate between the two groups (P>0.05). The non-disruptive group had shorter time to semi-liquid abnormal food intake and shorter operative time if compared to the traditional group (P<0.05). The non-disruptive group had less intraoperative blood loss than the traditional group (P<0.05). Both groups showed a significant increase in postoperative day 1 and day 5 gastric fluid pH values compared to preoperative level, while the non-disruptive group had even higher pH value on postoperative day 5 than the traditional group (P<0.05). Both groups showed a significant improvement in postoperative appetite, mental state, family understanding and cooperation, sleep quality, daily life, and cancer awareness compared to before surgery (P<0.05), and the non-disruptive group had higher postoperative scores than the traditional group (P<0.05). 【Conclusion】 Compared to traditional laparoscopic Roux-en-Y anastomosis for radical distal gastrectomy, the use of non-disruptive Roux-en-Y anastomosis for radical distal gastrectomy in treating patients with T14aN03M0 gastric cancer significantly shortens the operative time, reduces intraoperative blood loss, and significantly improves patients' quality of life, warranting its clinical promotion and use.
季良贵, 李宁, 叶中林. 腹腔镜非离断Roux-en-Y吻合远端胃癌根治术治疗T1~4aN0~3M0胃癌的疗效[J]. 医学临床研究, 2025, 42(4): 642-644.
JI Lianggui, LI Ning, YE Zhonglin. Efficacy of Laparoscopic Roux-en-Y Distal Anastomosis for Radical Gastrectomy of T1-4aN0-3M0 Gastric Cancer. JOURNAL OF CLINICAL RESEARCH, 2025, 42(4): 642-644.
[1] 田庆林,李阳,陈晓峰.腹腔镜远端胃癌根治术毕Ⅱ式联合Braun吻合术对胃癌肠道屏障功能血清炎性因子水平的影响[J].河北医学,2020,26(01):41-45. [2] 任宁,刘现立,卫利民,等.全腹腔镜远端胃癌根治术中2种吻合方式临床疗效的对比[J].中国现代普通外科进展,2020,23(3):197-199. [3] 吕豪,吴刚.Uncut Roux-en-Y吻合与毕Ⅱ式吻合在腹腔镜远端胃癌根治术中的对比研究[J].医药论坛杂志,2020,41(5):48-52. [4] ZHANG Y, CHEN H, YU W, et al. The effects of uncut Roux-en-Y anastomosis on laparoscopic radical gastrectomy patients' postoperative complications and quality of life[J].Am J Transl Res,2021,13(8): 9530-9537. [5] 叶小双.腹腔镜远端胃癌根治术非离断Roux-en-Y吻合与BillrothⅡ+Braun吻合的临床研究分析[D].重庆:中国人民解放军陆军军医大学,2022. [6] 施珊格,黄宝桑,邹庆杰,等.非离断式Roux-en-Y吻合在远端胃癌D2根治术中的临床应用[J].消化肿瘤杂志(电子版),2021,13(2):99-102. [7] 蔡晓东,吴红月,张彦春,等.非离断式Roux-en-Y吻合术在胃癌消化道重建手术中的临床应用[J].实用癌症杂志,2021,36(11):1837-1840. [8] 周兵奇,苗卓,王向征.腹腔镜远端胃癌根治术非离断空肠Roux-en-Y吻合对术后胃食管反流的影响[J].中国现代普通外科进展,2021,24(6):486-488. [9] 池元龙,林葆,张振.全腹腔镜非离断式Roux-en-Y吻合术在远端胃癌根治术中的应用[J].中国现代医药杂志,2021,23(8):43-46. [10] LI Y, WANG Q,YANG K L,et al. Uncut Roux-en-Y might reduce the rate of reflux gastritis after radical distal gastrectomy:An evidence mapping from a systematic review[J].Int J Surg,2022,104: 106184. [11] 王衡兵,胡立平,吴家伟,等.Roux-en-Y术式重建消化道对胃癌的疗效及术后并发症的影响[J].中国现代普通外科进展,2022,25(5):394-396. [12] JIAO Y J, LU T T, LIU D M, et al. Comparison between laparoscopic uncut Roux-en-Y and Billroth with Braun anastomosis after distal gastrectomy: a meta-analysis[J].World J Gas Surg,2022, 14(6): 594-610.
2025, Vol. 42 
