Retention Of Double-channel Digestive Tract Reconstruction With Residual Stomach And Jejunum In Esophagogastric Junction Cancer

Objective:Analysis and comparison of the differences in safety,efficacy,postoperative complications,quality of life and prognosis between the two-way digestive tract reconstruction with residual gastric jejunum and total gastrectomy(Roux-en-Y)The feasibility and clinical value of dual-channel digestive reconstruction.Methods:60 cases of surgical patients admitted to the Second Affiliated Hospital of Kunming Medical University from July 2016 to September 2018 according to the criteria for meeting the criteria and the exclusion criteria(definitely diagnosed as Siewert Ⅱ,Siewert Ⅲ type esophagogastric junction)Adenocarcinoma was divided into groups and included in the study,including 29 patients with residual gastrojejunostomy and digestive tract reconstruction(experimental group),and 31 patients with total gastrectomy Roux-en-Y jejunal esophagus anastomosis(control group).There were no significant differences in gender,age,and underlying disease between the two groups.A comprehensive analysis of the indexes of the two groups of patients during and after surgery was conducted to analyze the safety of the two different surgical methods,and the effects of the two groups on postoperative complications and long-term quality of life.The application prospect and value of residual gastro-jejunum double-channel digestive tract reconstruction in clinical practice.Results:Both groups of patients successfully completed the operation.Through the observation and comparative analysis of the intraoperative and postoperative conditions of the two groups of patients,the preoperative general clinical data,operation time,postoperative intestinal function recovery time,hospitalization days,surgery There was no significant difference in the incidence of postoperative early complications and postoperative dumping syndrome,anastomotic stomatitis,and anastomotic stenosis(P>0.05).There was a significant difference in the incidence of reflux esophagitis(p<0.05).The group was significantly lower than the control group.By comparing the plasma total protein,albumin,prealbumin and hemoglobin content and body weight changes in the two groups after operation,the nutritional status of the experimental group was significantly better than that of the control group,the difference was statistically significant(P<0.05).The implementation of residual gastro-jejunum double-channel digestive tract reconstruction has more advantages than traditional total gastrectomy Roux-en-Y jejunal esophagus anastomosis.Conclusion:Siewert Ⅱ,Ⅲ type esophagogastric junction adenocarcinoma patients with residual gastric jejunal double-channel digestive reconstruction,compared with the total safety of Roux-en-Y jejunal esophagus anastomosis surgery and early postoperative complications,no significant difference,not Increase the difficulty of surgery,but the incidence of postoperative reflux esophagitis is significantly reduced,postoperative nutritional status is better,significantly improve the quality of postoperative quality,clinical efficacy can be,is the ideal way of reconstruction of the digestive tract in such patients,Clinical application value.