关键词: 远端, 胃癌, 生活质量, Billroth Ⅱ吻合, 未离断 Roux-en-Y吻合

Abstract:

Objective To compare postoperative quality of life between Billroth Ⅱ and uncut Roux-en-Y anastomosis in patients undergoing radical distal gastrectomy for gastric cancer. Method The clinical data of 60 patients who received radical distal gastrectomy in Dongfang Hospital Affiliated to Tongji University from November 2019 to August 2022 were collected. The patients were divided into two groups according to the postoperative digestive tract reconstruction: Billroth Ⅱ anastomosis group (B- Ⅱ group) and uncut Roux-en-Y anastomosis group (uncut R-Y group). The Chinese version of the postgastrectomy syndrome assessment scale (PGSAS)-37 was used to evaluate and compare the differences between the two groups in the field of symptoms, life status and quality of life. Result A total of 60 patients were included in this study, including 26 patients in group B- Ⅱ and 34 patients in uncut R-Y group. There were no significant differences in age, gender and postoperative follow-up time distribution between the two groups (P ＞ 0.05). In terms of surgical methods, the proportion of laparoscopic surgery (including laparoscopic assisted surgery and total laparoscopic surgery) in the uncut R-Y group was significantly higher than that in the B- Ⅱ group (χ2=17.532, P=0.001). PGSAS-37 score showed that the gastric acid reflux symptoms in the uncut R-Y group were significantly better than those in the B-Ⅱ group (P=0.044); There was no significant difference in other symptoms, life status and quality of life between the two groups (P ＞ 0.05). Conclusion Uncut Roux-en-Y anastomosis demonstrated superiority over B- Ⅱ anastomosis regarding acid reflux symptoms after distal gastrectomy. However, no significant differences were found in other quality of life aspects.

Key words: Distal end, Gastric cancer, Quality of life, Billroth 2 anastomosis, Uncut Roux-en-Y anastomosis