Comparative Study of the Application Value of Pants-Type Anastomosis and Roux-en-Y Anastomosis after Total Gastrectomy for Gastric Cancer
Objective:To compare the application value of pants-type anastomosis and Roux-en-Y(RY)anastomosis after total gastrectomy for gastric cancer.Methods:A total of 108 patients with gastric cancer who underwent total gastrectomy at our hospital from January 2020 to May 2023 were selected as the re-search subjects.They were divided into the RY anastomosis group(n=54)and the pants-type anastomosis group(n=54).Both groups underwent total gastrectomy,and the RY anastomosis group and the pants-type anastomosis group underwent digestive tract reconstruction with RY anastomosis and pants-type anastomosis af-ter total gastrectomy for gastric cancer,respectively.The surgical indicators,postoperative complications,nu-tritional indicators[total protein(TP),hemoglobin(Hb),serum albumin(ALB),and prognostic nutritional index(PNI)],quality of life(QLQ-C30),and the incidence of long-term adverse events were compared between the two groups.Results:There was no significant difference in surgical indicators between the two groups(P>0.05).One case in the RY anastomosis group had the stapler replaced due to intestinal size rea-sons.The replacement rate of the stapler in the RY anastomosis group was higher than that in the pants-type anastomosis group,but the difference was not significant(P>0.05).The total incidence of postoperative com-plications in the pants-type anastomosis group was lower than that in the RY anastomosis group(P<0.05).The total incidence of long-term adverse events in the pants-type anastomosis group was lower than that in the RY anastomosis group(P<0.05).Compared with the preoperative values,the nutritional evaluation indica-tors TP,Hb,ALB,and PNI in both groups were increased at 3 and 6 months after surgery,and gradually in-creased with the extension of the postoperative time(P<0.05).The values of TP,Hb,ALB,and PNI were higher in the pants-type anastomosis group than in the RY anastomosis group at 3 and 6 months after surgery(P<0.05).Compared with the preoperative values,the QLQ-C30 scores of both groups were increased at 3 and 6 months after surgery,and gradually increased with the extension of the postoperative time(P<0.05).The QLQ-C30 scores of the pants-type anastomosis group were higher than those of the RY anastomosis group at 3 and 6 months after surgery(P<0.05).Conclusion:Compared with RY anastomosis after total gastrecto-my for gastric cancer,pants-type anastomosis has a lower incidence of complications and is superior to RY an-astomosis in terms of anti-bile reflux,reflux esophagitis,and food emptying disorder.Patients can obtain bet-ter nutritional support after surgery,and their quality of life is significantly improved,with higher application value.
万方数据
维普
