Clinical Comparative Research Of Digestive Tract Reconstruction Of Totally Laparoscopic Distal Gastrectomy For Gastric Cancer

Objective To investigate the clinical curative effects of three kinds of digestive tract reconstruction(Billroth II,Roux-en-Y and BillrothⅠanastomosis)of laparoscopy D2 radical gastrectomy for distal gastric cancer in Qinghai area,in order to provide a theoretical basis of digestive tract reconstruction for the future in this region.Method We collected 73 patients’ cases which accepted laparoscopy D2 radical gastrectomy for distal gastric cancer with complete data in department of gastrointestinal oncological surgery of Qinghai University Affiliated Hospital during April 2015 to October 2016 in this study.27 cases were treated with Billroth II anastomosis.22 cases were treated with Roux-en-Y anastomosis.24 cases were treated with BillrothⅠ(Delta)anastomosis.Compared and analysed the indicators of three groups of patients with the duration of operation(min),the amount of bleeding(ml),postoperative exhausting time(h),active time post-operation(h),feeding enteral nutrition time(h),eating liquid food time(h),postoperative hospital stay(d),hospitalization expenses(y)and the postoperative complications(n)by using SPSS22.0 statistical software.Results 1.There are no statistical differences between the three groups of patients through the comparative analysis with general information,including gender,age,body mass index(BMI),clinical pathological stage,postoperative exhausting time,active time post-operation,feeding enteral nutrition time,eating liquid food time,hospitalization expenses.2.There are significant statistical differences between Billroth II anastomosis group,Roux-en-Y anastomosis group and BillrothⅠanastomosis in the duration of operation,the amount of bleeding(P<0.05).According to comparison between the two-two groups,Billroth Ⅰ(201.92±9.35 min,101.63±7.64ml)was found to be less than Billroth II(237.89 ± 8.74 min,145.52 ± 10.38ml)and Roux-en-Y(240.82 ±10.16 min,149.73±8.37ml).Three groups of postoperative hospital stay wasstatistically significant.According to comparison between the two-two groups,Roux-en-Y(10.41±1.65d)was found to be less than Billroth II(13.00±3.08d)and Billroth Ⅰ(12.46±3.71d).3.Alkaline reflux gastritis of Roux-en-Y anastomosis group after operations were significantly lower than that of Billroth II and Billroth I anastomosis group(P<0.0125).Conclusion Compared with Billroth II and Billroth I anastomosis,Roux-en-Y anastomosis has the advantages of anti reflux and shorter postoperative hospital stay.The amount of bleeding,the duration of operation were more favorable for Billroth I anastomosis.