Application of Laparoscopic Gastric Jejunum Uncut Roux-en-Y Anastomosis

Abstract

Background. Uncut Roux-en-Y gastrojejunostomy, recently developed in China, is useful in the treatment of distal gastric cancer. This study is aimed at comparing laparoscopic gastric jejunum uncut Roux-en-Y anastomosis with conventional anastomosis in the surgical treatment of distal gastric malignancy. Methods. In this retrospective study, the clinical data of 178 patients and their follow-up records were analyzed. 112 cases (uncut group) were the observation group for stomach jejunum uncut Roux-en-Y anastomosis, the control group for the stomach, 66 cases (conventional group) were for jejunum Roux-en-Y anastomosis and Billroth I and Billroth II anastomosis. A comparison between the two groups was conducted based on the general situation of the patients, TNM stage, and one-year survival rate. Results. There was no significant difference reported between the two groups in terms of the general situation and TNM stage. A comparison on postoperative complications between the two groups revealed that the postoperative bleeding was 0.9% and 6.1%, the bile reflux gastritis was 1.8% and 9.1%, the anastomotic leakage was 0.0% and 3.0%, the delayed gastric emptying was 0.9% and 7.6%, and the overall complications was at 3.6% and 25.8%, which was significantly lower in the observation group than in the control group, and the difference was statistically significant. Notably, there was no significant difference in 1-year survival rate between the two groups. Conclusion. Laparoscopic gastric jejunal uncut Roux-en-Y anastomosis significantly reduces the risk of postoperative complications of the digestive tract. Its operation is easy and exhibits an effective curative effect.

Efficacy and safety of totally laparoscopic gastrectomy with Uncut Roux-en-Y for gastric cancer: A dual-center retrospective study

“…At present, surgical treatment in the eld of GC is more about reducing long-term complications than simply improving survival. The long-term complications that existed after RY anastomosis, especially RSS, were greatly relieved by URY anastomosis [21,29,36]. Data from this study showed that the long-term complication of RY was twice that in the URY group (P < 0.001).…”

“…The study of TLTG combined with URY for GC has con rmed that the postoperative short-term complications of URY were signi cantly less than those of the RY group [21]. The short-term prognostic advantages of LDG combined with URY for GC were also validated [29]. From the perspective of postoperative recovery, URY is more suitable for GC patients than RY.…”

“…Totally laparoscopic digestive tract reconstruction has high technical requirements for doctors. RY anastomosis was one of the most surgical procedures of GC in the past few decades [29]. However, RY anastomosis destroys the normal anatomical structure of the gastrointestinal tract and seriously affects the QoL of patients.…”

“…URY was gradually applied to GC because of its simplicity [30]. URY can effectively reduce RSS caused by digestive tract reconstruction and increase QoL [21,29,31]. However, whether URY has input loop recanalization [32], and whether it can improve the long-term prognosis of GC patients are currently a research focus [21].…”

Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study

“…Totally laparoscopic digestive tract reconstruction demands a high level of technical proficiency from physicians. RY anastomosis was one of the most common surgical procedures of GC in the past few decades [ 29 ]. However, RY anastomosis disrupts the normal anatomical structure of the gastrointestinal tract and seriously affects the QoL of patients.…”