A Meta-analysis Of Uncut Roux-en-Y And Billroth Ⅱ-braun Gastrointestinal Reconstruction After Radical Resection Of Distal Gastric Cancer

Objective : To systematically evaluate the clinical efficacy of Uncut Roux-en-Y anastomosis and Billroth-Braun anastomosis after radical resection of distal gastric cancer,and to provide basis for the selection of digestive tract reconstruction methods after radical resection of distal gastric cancerMethods:Clinical studies comparing Uncut roux-en-y(URY)and Billroth-Braun(BB)digestive tract reconstruction methods after radical gastrectomy for distal gastric cancer were collected by searching Pub Med Embase Cochrane Library CNKI and Wanfang database.The information retrieved in this paper has a long time span,Using a random effects model combined odds ratio and 95% confidence interval of the weighted mean difference.Differences in perioperative clinical indicators(operation time,the digestive tract reconstruction time,and postoperative short-term and long-term complications(intestinal obstruction,anastomotic fistula,gastric paralysis,dumping of symptoms,bile reflux,reflux gastritis)were compared..Results: In this paper,we used the random and non random method to divide the groups,involving three randomized controlled trials,in addition,we also set up five non random observation clinical studies.After excluding the cases that did not meet the standard,we included 455 patients in ury group,and 443 patients in the other group.Results of meta-analysis showed that the incidence of bile reflux(OR=0.05,95%CI 0.02 ～ 0.12,P< 0.00001)and reflux gastritis(OR=0.10,95%CI 0.06 ～ 0.19,P< 0.00001)was lower in Ury group compared with BB group.There were no significant differences in operative time,reconstruction time of digestive tract,intraoperative blood loss,postoperative hospital stay,intestinal obstruction,anastomotic fistula,gastroparesis,and dumping symptoms(P> 0.05).Conclusion:This reconstruction method of Uncut roux-en-y has the advantage of low incidence of bile reflux reflux gastritis and is worthy of application and popularization.