Abstract
Aim
Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after distal gastrectomy. A new reconstruction method, which was modified from the classic Roux-en-Y procedure, the continuous jejunal pouch and residual stomach anastomosis combined with jejunal lateral anastomosis (Contin-L), was established. In order to fully clarify the superiority of this procedure, this study has conducted a systematic analysis and prepared a summary of the clinical data of patients who underwent distal gastrectomy for gastric cancer.
Methods
From June 2013 to March 2016, we enrolled 198 patients with gastric cancer who underwent radical D2 distal gastrectomy. According to the reconstruction methods, these patients were divided into three groups: Contin-L (n = 74), Billroth II (n = 59), and Roux-en-Y (n = 65) groups. The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick grading were analyzed.
Results
Regarding long-term complications, such as reflux gastritis, the Contin-L procedure showed significantly better results than Billroth II (p < 0.0001). Regarding the long-term postoperative nutritional status, such as the PNI and body weight recovery, the Contin-L procedure displayed significantly better results than Billroth II and Roux-en-Y (p < 0.05). Postoperative subjective feelings evaluated by Visick grading were significantly more improved in the Contin-L than in the Billroth II and Roux-en-Y groups (p ≤ 0.01).
Conclusions
The Contin-L procedure gave full play to the advantages of jejunal continuity, and pouch and lateral anastomoses, which significantly reduced short- and long-term complications, and improved the long-term patient quality of life following the surgical procedure.
Disclosure statement
The authors declare that there are no conflicts of interest. The authors are responsible for the content and writing of the article.
Ethics statement
This clinical study was approved by the ethics committees of the General Hospital of western Theater Command and Chendu XinHua Hospital, and part of the clinical data came from the General Hospital of western Theater Command. Consent and signature confirmations for this study were obtained from all patients or their families.