| Objective:During radical gastrectomy of distal gastric cancer,the way of digestive tract reconstruction affects the postoperative quality of life of patients.In this study,the postgastrectomy Syndrome Assessment Scale(PGSAS-37)was used to compare the effects of B-Ⅰ anastomosis,B-Ⅱ anastomosis and Uncut Roux-en-Y anastomosis on postoperative quality of life of patients undergoing radical gastrectomy for distal gastric cancer.Thus,it can provide reference for clinicians to select the appropriate surgical methods,and help patients to better recovery and life after surgery.Methods:Retrospective study method was adopted.Inclusion criteria: 1)Age 18-80 years old;2)The patient was pathologically confirmed as gastric malignant tumor and received radical gastrectomy for distal gastric cancer;3)History of first gastrectomy;4)Postoperative time is more than 1 month;5)No history of other diseases that may affect the results of this investigation;6)Informed and willing to accept this study.According to the above criteria,clinical data of 83 patients undergoing radical gastrectomy for distal gastric cancer admitted to the gastroentero-anorectal Surgery Department of East Hospital Affiliated to Tongji University from November 2019 to August 2022 were retrospectively collected,including 23 patients undergoing BI anastomosis.A total of26 cases underwent B-Ⅱ anastomosis.Uncut Roux-en-Y anastomosis was performed in34 cases.The symptom domain,life status domain and quality of life domain of the three groups were compared with PGSAS-37 designed by the Chinese version of Japan Working Group on Post-gastrectomy Syndrome(JPGSWP),and the postoperative quality of life of the three groups was comprehensively evaluated.SPSS22.0 statistical software was used to analyze the above statistical data of patients with B-Ⅰ anastomosis,B-Ⅱ anastomosis and Uncut Roux-en-Y anastomosis.For measurement data,it is expressed as mean ± standard difference.Significant Difference(LSD)method was used for the subsequent paired comparison if the normal distribution was denoised.Then significantdifference(LSD)method was used.Mann-whitney U or Kruskai-Wallis tests with independent samples were used for non-normal distributions.The Chi-square test of R×C table data was used to compare categorical variables among multiple groups,and P < 0.05 was considered statistically significant.Results : 1.Symptom domiain: In terms of whether there was stomach pain or discomfort(P= 0.015)and acid reflux symptoms(P= 0.025),B-Ⅱ anastomosis showed better results than B-Ⅰ anastomosis.At the same time,the Uncut Roux-en-Y anastomosis also showed better effects than the B-Ⅰ anastomosis in terms of stomach pain and discomfort(P= 0.001),acid reflux symptoms(P < 0.001)and mouth pain(P= 0.014).2.Life status domain: Including the average daily staple food frequency(P= 0.002),B-Ⅱ anastomosis was significantly less than B-Ⅰ anastomosis,the difference was statistically significant.In terms of physical status in the past month(P= 0.014),Uncut Roux-en-Y anastomosis also showed obvious advantages over B-Ⅰ anastomosis.3.Life quality domain:B-Ⅱ anastomosis also showed better results than B-Ⅰ anastomosis in the degree of dissatisfaction with chest and abdominal symptoms(P=0.013).No significant statistical difference was found in the three reconstruction methods of the other items(P > 0.05).Conclusion:The postoperative quality of life of gastric cancer patients who received Uncut Roux-en-Y and B-Ⅱ anastomosis during radical gastrectomy was better than B-Ⅰ anastomosis.No statistically significant difference was found in postoperative quality of life in patients receiving Uncut Roux-en-Y and B-Ⅱ anastomosis,both of which could improve the quality of life in patients undergoing radical resection of distal gastric cancer. |
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