Clinical Comparative Analysis Of Three Common Ways To Reconstruct Digestive Tract After Radical Resection For Distal Gastric Cancer

Background:Data show that the incidence of gastric cancer patients in China ranks second in the world.Each year about 679100 people diagnosed with gastric cancer,498,000 people died of gastric cancer.Among them,distal gastric cancer accounts for about 50%.So far the only way to clinically cure gastric cancer is only surgical-based comprehensive treatment.Gastrointestinal cancer after radical resection of the method after many years of development and improvement after a variety of which,in our country after radical gastrectomy,the most commonly used anastomosis of the three main,namely Billroth ?,Billroth ? and Roux-en-Y anastomosis,three kinds of anastomosis have their own advantages and disadvantages,there is no clinically recognized the best choice.In this paper,three kinds of gastric cancer postoperative gastrointestinal reconstruction of clinical data for comparative analysis,in order to be able to radical gastrectomy after radical resection of the rational choice to provide a clinical basis.Objective:Through the clinical comparative study,the rationality of the three common gastrointestinal reconstruction methods after radical gastrectomy was discussedMethods:Through retrospective selection from September 2014 to March2016 in Jilin University,Department of Gastrointestinal Surgery in the Japanese University of distal gastric cancer after radical resection of patients with gastrointestinal reconstruction.Patients with no previous abdominal surgery history,preoperative hospital clear pathology report confirmed gastric cancer,lesions located in the lower part of the stomach or part of the small side of the stomach.Combined with preoperative CT,ultrasound and other auxiliary examination no distant metastasis,preoperative adjustment of the physical state can tolerate surgery,limited to the end of radical surgery for distal gastric surgery,postoperative pathology consistent with preoperative pathology.There were 87 patients in the group,including Billroth ? in 22 cases,Billroth ? type 32 cases,Roux-en-Y anastomosis in 33 cases.(D),postoperative hospital stay(d),postoperative recovery of gastrointestinal function,the number of patients after surgery(perioperative period),intraoperative blood loss(ml),gastrointestinal function recovery time(d)Postoperative follow-up survey of special symptoms in June,postoperative complications within 1year and other indicators for statistical analysis.Results:1.There were no significant differences in the general clinical data of age,sex,pathological type and TNM stage(P> 0.05).There was no statistical significance and comparability.2.There was a positive correlation between the operation time andintraoperative blood loss in the three groups,the simplest operation of Billroth ? anastomosis,the least duration of operation and the least amount of bleeding during operation,and Roux-en-Y anastomosis(P<0.05).Roux-en-Y anastomosis group was significantly higher than that of Roux-en-Y anastomosis group(P <0.05).The Roux-en-Y anastomosis group was the most complicated,The time of extubation and oral feeding was also longer than that of Billroth ?,and the difference was statistically significant(P <0.05).3.The scores of the Chew-wun Wu Special Symptom Scale in the three groups were compared with the Billroth ? anastomosis and the Billroth ? anastomosis group,respectively,in which the Rouro-en-: 1.69± 0.31;Billroth ? anastomosis: 1.58 ± 0.49;Roux-en-Y anastomosis:2.15 ± 0.63),lower than the other two groups,P <0.05,statistically significant.There were no significant differences in other symptom scores.4.The complication of Roux-en-Y group and Billroth-I group was significantly lower than that of the control group(P <0.05),and the difference was statistically significant(P> 0.05).The incidence of complications in Billroth ? group was significantly higher than that in Roux-en-Y group or Billroth-I group(P <0.05),but there was no significant difference between the two groups <0.05).Conclusions:The three types of gastrointestinal remodeling,which are commonly used in radical gastrectomy,have long pros and cons.Based on the clinical evidence to date,Billroth ? is simple and conditional for the first choice;Billroth ? is simpler than Roux-en-Y,But more complications;Roux-en-Y operation complicated,slow recovery of gastrointestinal function.But the reconstruction of anti-reflux effect is significantly better than Billroth ? and Billroth ? type reconstruction,long-term quality of life of patients is worth promoting.