Correlation Analysis Of The Effect Of Gastroesophageal Reconstruction And Dual-Channel Reconstruction After Proximal Gastrectomy

ObjectiveThis study aims to further clarify the advantages and disadvantages of different digestive tract reconstruction methods after proximal gastrectomy by comparing and studying the intraoperative operation time,intraoperative bleeding,ventilation time,defecation time,eating time,postoperative discharge time,postoperative complications and postoperative nutritional index changes of double-channel jejunal interposition and direct esophagogastric anastomosis reconstruction after proximal gastrectomy,Decide which reconstruction method is more reliable,and then provide a reliable basis for clinicians’ diagnosis and treatment,guide the selection of appropriate anastomosis method for clinical treatment of proximal gastric cancer,and also improve the quality of life of patients after surgery.MethodBy searching the hospital medical record system,a total of 96 patients who underwent proximal gastrectomy from January 2020 to December 2022 were included according to the established inclusion and exclusion criteria.Then,by collecting the relevant clinical data of patients,96 patients who were included in the criteria were divided into control group and observation group according to the different anastomosis methods.The control group adopted dual-channel jejunal interposition,and the observation group adopted direct esophagogastric anastomosis reconstruction.The general data(age,sex,BMI,tumor differentiation,tumor diameter,Siewert classification,postoperative TNM stage),perioperative indexes(operation time and blood loss were significantly greater than those of the control group;the observation group’s ventilation time,defecation time,eating time,and hospitalization time)Postoperative complications(gastroesophageal reflux,anastomotic complications,gastric retention)and postoperative nutritional indicators(single feeding amount,serum gastrin,hemoglobin,albumin,and body weight increase).SPSS26.0 software was used for statistical data processing,and P<0.05 was statistically significant.Results1.The general data of the two groups of patients: age,sex,BMI,tumor differentiation,tumor diameter,Siewert classification,postoperative TNM stage,etc.were not statistically different after analysis and comparison(P>0.05).2.The operation time and blood loss in the observation group were significantly longer than those in the control group;The ventilation time,defecation time,eating time and hospitalization time of the observation group were significantly shorter than those of the control group,and the above differences were statistically significant(P<0.05).3.The operation time and blood loss in the observation group were significantly longer than those in the control group;The ventilation time,defecation time,eating time and hospitalization time of the observation group were significantly shorter than those of the control group,and the above differences were statistically significant(P<0.05).The number of cases of gastroesophageal reflux,anastomotic complications,and gastric retention in the observation group was smaller than that in the control group,and the total incidence of postoperative complications was significantly lower than that in the control group with statistical difference(P<0.05).4.The level of food intake,serum gastrin,hemoglobin,albumin and weight increase in the observation group were significantly higher than those in the control group(all P < 0.05).Conclusion1.Compared with direct esophagogastric anastomosis,dual-channel jejunal interposition can ensure more safe completion of the operation,more patient tolerance for postoperative recovery,and better short-term recovery.2.Compared with direct esophagogastrostomy,double channel jejunal interposition has a significant effect on reducing the incidence of gastroesophageal reflux after replacement,and also has advantages in preventing gastric retention and anastomotic stenosis3.Compared with direct esophagogastric anastomosis,the advantage of dual-channel jejunal interposition is that it can effectively improve the nutritional status of patients after operation,and the recovery of nutritional status after operation is faster.