Efficacy of Billroth II anastomosis versus Roux-en-Y anastomosis in laparoscopic distal gastrectomy for gastric cancer
10.3760/cma.j.cn341190-20230821-00110
- VernacularTitle:BillrothⅡ式与Roux-en-Y吻合在腹腔镜下远端胃癌根治术中的疗效比较
- Author:
Hui CAO
1
;
Yongqiang JIANG
;
Luohai LIU
;
Tao ZHENG
;
Bao JIANG
Author Information
1. 淮南东方医院集团总医院普外科，淮南 232001
- Keywords:
Stomach neoplasms;
Laparoscopy;
Gastrectomy;
Gastroenterostomy;
Anastomosis,Roux-en-Y;
Postoperative complications;
Postgastrectomy syndromes
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(9):1363-1367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of Billroth II anastomosis versus Roux-en-Y anastomosis in laparoscopic distal gastrectomy for gastric cancer. Methods:A case-control study was conducted to retrospectively analyze the clinical data of 110 patients who underwent laparoscopic distal gastrectomy for gastric cancer at the General Hospital of Huainan Oriental Hospital Group from January 2021 to December 2022. According to the different methods of gastrointestinal reconstruction after distal gastrectomy, the patients were divided into an observation group ( n = 61) and a control group ( n = 49). The observation group was treated with Roux-en-Y anastomosis, while the control group received Billroth II anastomosis. The intraoperative blood loss, operation time, postoperative recovery, early postoperative ambulation time, time to first flatus, food intake, length of hospital stay, and complications were compared between the two groups. Results:The operation time in the control group was (140.0 ± 31.5) minutes, which was significantly shorter than that in the observation group [(180.0 ± 30.5) minutes, t = 6.37, P < 0.05]. There were no statistically significant differences in intraoperative blood loss and early postoperative ambulation time between the two groups (both P > 0.05). In the control group, there were 8 cases of alkaline reflux gastritis (16.3%), 3 cases of afferent loop obstruction (6.1%), and 3 cases of dumping syndrome (6.1%). These proportions were significantly higher than those in the observation group, which reported 2 cases of alkaline reflux gastritis (3.3%), 1 case of afferent loop obstruction (1.6%), and 1 case of dumping syndrome (1.6%) (χ2 = 6.15, 4.54, 4.54, all P < 0.05). Conclusion:Using Roux-en-Y anastomosis for gastrointestinal reconstruction in patients undergoing laparoscopic distal gastrectomy for gastric cancer can help prevent against alkaline reflux gastritis, afferent loop obstruction, and dumping syndrome; however, it results in a longer surgical time compared with Billroth II anastomosis.
