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Efficacy of Laparoscopic Roux-en-Y Distal Anastomosis for Radical Gastrectomy of T1-4aN0-3M0 Gastric Cancer |
JI Lianggui, LI Ning, YE Zhonglin |
General Surgery, Gushi County Third People's HospitalXuji Town Central Health Center, Xinyang Henan 465200 |
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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.
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Received: 27 March 2023
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