Clinical Effect And Safety Of Billroth I Anastomosis Based On The Totally Laparoscopic Gastrectomy And Laparoscopically Assisted Distal Gastrectomy For Patients With Gastric Cancer

ObjectiveTo observe the clinical effect and safety of Billroth I anastomosis based on the totally laparoscopic gastrectomy and laparoscopically assisted distal gastrectomy for patients with gastric cancer.MethodsData were retrospectively collected from April 2016 to December 2016 in the First Affiliated Hospital of Soochow University which were diagnosed with primary gastric cancer.100 patients were matched.The subjects were divided into two groups by their operation mode,50 cases each group.The observation group adopted the Billroth I anastomosis based on the totally laparoscopic gastrectomy;the control group adopted the Billroth I anastomosis based on the laparoscopically assisted distal gastrectomy.The patients were followed up for 3 months after operation,the short-term effect was observed;during surgery,the index of incision size,dissected lymph node number,proximal incisal edge and distal incisal edge,blood loss,reconstruction time of alimentary canal and operation time was compared;the postoperative index of hospitalization cost,hospitalization time and initial exhaust time as well as the incidence rate of complications like weight loss,gastrorrhagia,anastomotic stenosis,anastomotic fistula,anastomotic bleeding and hypoglycemia for two groups was compared.ResultsThe short-term effective rate for observation group and control group both were 100.0%;the operation time for observation group was longer than control group(P<0.05);during surgery,the reconstruction time of alimentary canal for control group was shorter than observation group(P<0.05);the blood loss,clinical index of incision size,dissected lymph node number,proximal incisal edge and distal incisal edge,for two groups was not significantly different(P>0.05);the hospitalization cost and hospitalization time for two groups was not significantly different(P>0.05);the initial exhaust time for observation group was shorter than control group(P<0.05);the incidence rate of complications like dumping symptoms,weight loss,gastroparesis,anastomotic fistula,anastomotic stenosis,anastomotic bleeding and hypoglycemia for observation group was 4.0%;the incidence rate of complications like weight loss,gastroparesis,anastomotic fistula,anastomotic stenosis,anastomotic bleeding and hypoglycemia for control group was 16.0%(P<0.05).ConclusionsFor patients with distal gastric cancer,the short-term clinical effect of the totally laparoscopic distal gastrectomy and laparoscopically assisted distal gastrectomy is not significantly different;however,the Billroth I anastomosis based on the totally laparoscopic gastrectomy can reduce the incidence rate of postoperative complications and improve the clinical safety and feasibility.It is worthy of clinical promotion.