Objective To investigate the safety and efficacy of modified π-type anastomosis in laparoscopic total gastrectomy(LTG)for digestive tract reconstruction.Methods The clinical data of 80 patients with gastric cancer who received LTG from January 2018 to January 2023 were retrospectively analyzed.Among them,36 patients received LTG(improved group)by improved π-shaped anastomosis,and 44 patients received LTG(π-shaped group)by traditional π-shaped anastomosis.The data were analyzed using SPSS 22.0 software,and the measurement data such as intraoperative conditions and postoperative recovery were expressed by((x)±s),and independent t test was performed.The statistical data of postoperative complications were x2 test.Kaplan-Meier method and Log-Rank test were used for survival analysis.P＜0.05 was considered statistically significant.Results The operation time and anastomosis time of the improved group were significantly reduced compared with the π-shaped group(P＜0.05),and the distance of the upper incisal margin was significantly extended(P＜0.05).There was no significant difference in intraoperative blood loss,number of lymph node dissection,incision length,postoperative recovery and postoperative survival between the two groups(P＞0.05),and postoperative gastroscopy or gastrointestinal angiography showed that the anastomosis was patency in both groups.The overall incidence of postoperative complications in the improved group was significantly lower than that in the π-shaped group(11.1％vs.29.5％,P＜0.05).The median follow-up was 37(5～64)months.There was no significant difference in cumulative overall survival(83.3％vs.77.3％)and disease-free survival(80.6％vs.75.0％)between the two groups(P=0.830,0.846).Conclusion The modified π-shape anastomosis is safe and effective in the digestive tract reconstruction of LTG,which not only reduces the difficulty of surgery,shorens the operation time,but also obtains a higher safe incision margin,effectively reduces the occurrence of postoperative complications,and improves the safety of surgery.
维普
万方数据