Effects Of Different Reconstruction Methods On Gastrointestinal Function And Iron Metabolism After Radical Gastrectomy

Objective: Researching the effects of two types of gastrointestinal reconstructions,Regulatory double-tract digestive channel reconstruction(R-Dcr)and Roux-en-Y anastomosis,on gastrointestinal function and levels of iron metabolism in patients with gastric cancer after radical gastrectomy,expounding the law of iron metabolism after radical gastrectomy,and providing scientific evidence for the selection of digestive tract reconstruction in gastrectomy.Methods: Between January 2021 and January 2022,50 patients who had undergone radical resection for stomach cancer at the Sichuan Mianyang 404 Hospital served as research participants and were randomly divided into two groups,each with 25 cases: the control group chose Roux-en-Y reconstruction,the research group chose to perform regulatory double-tract digestive channel reconstruction;case inclusion criteria:(1)Age 18-70 years old;(2)No tumor metastasis or other primary tumors,no history of preoperative radiotherapy,chemotherapy or immunotherapy;(3)Without affecting the patient’s digestion and absorption,without diabetes and other metabolic disorders;(4)Oxaliplatin plus capecitabine is used in the postoperative chemotherapy regimen;(5)Patients voluntarily participate in cooperative clinical research and sign the relevant informed consent.Case exclusion criteria:(1)Prior history of intra-abdominal or gastrointestinal surgery;(2)Accident during surgery,pregnant and lactating women;(3)Other types of gastric cancer that do not meet the indications for radical gastrectomy;(4)Withdrawal from the trial.The baseline clinical characteristics(age,sex,comorbidities,BMI index,tumor stage,tumor differentiation,maximum tumor diameter and preoperative laboratory indicators)and indices representing the recovery of gastrointestinal function(anal exhaust time,stomach tube,etc.)were compared between the two groups.The time of removal and the time of first eating),as well as the re-examination of the iron metabolism-related index levels and the occurrence of complications in patients one month,six months,and one year following surgery.Results: 1.By comparing the baseline clinicopathological data of the two groups of patients,including age,gender,occurrence of complications,BMI index,tumor stage and degree of differentiation,maximum tumor diameter,and preoperative laboratory indicators,no statistically significant difference was found(P >0.05).2.There was no statistically significant difference in the related indicators of gastrointestinal function recovery between the two groups(P>0.05),and there was no statistically significant difference in the incidence of early and late postoperative complications between the study group and the control group(P>0.05).3.There was no significant difference in preoperative serum ferritin(SF)levels between the two groups(P>0.05);the postoperative time of the two groups was prolonged(1 month after operation,6 months after operation and 12 months after operation).months)SF levels showed a continuous downward trend(P<0.05);and the SF levels of the study group were significantly higher than those of the control group at 12 months after operation(P<0.05);serum iron(SI),total The index levels of iron binding capacity(TIBC)and transferrin saturation(TS)showed a continuous upward trend(P<0.05),and there was no difference in the above index levels between the two groups at 1month,6 months and 12 months after operation.Statistically significant(P>0.05).Conclusion:1.Compared with the Roux-en-Y digestive tract reconstruction,R-Dcr for gastric cancer is more in line with the natural anatomical and physiological structure,and has better iron absorption advantages.2.The incidence of anemia after Roux-en-Y digestive tract reconstruction was significantly higher than that after R-Dcr digestive tract reconstruction,and R-Dcr digestive tract reconstruction can effectively improve postoperative iron metabolism.3.There is no significant difference in the effect of the two kinds of digestive tract reconstruction and anastomosis on the recovery of gastrointestinal function in patients,and the risk of postoperative complications of the two reconstruction methods is similar,which further proves that radical resection of gastric cancer with regulatory double-tract digestive channel reconstruction has good safety.