Comparison Of Delta-shaped Anastomosis,Laparoscopic Assisted Billroth ? Reconstruction After Laparoscopic Distal Gastrectomy For Gastric Cancer

Aims: This study intends to compare the short-term effects and long-term survival of Delta-shaped anastomosis(DA)and laparoscopic assisted Billroth I reconstructions after laparoscopic distal gastrectomy for gastric cancer.Methods: We retrospectively collected data from 257 patients with gastric cancer who underwent laparoscopic distal gastrectomy between January 2013 and December 2017.Patients were classified into two groups according to reconstruction method used: the DA group(n=91),the Billroth I group(n = 166).The clinical data,short-term efficacy and long-term results were compared between the two groups.Results: The operation time(P < 0.001),and post-operative length of hospital stay(P < 0.001)were shorter in the DA group than in the Billroth I group.the time to the first oral intake of a soft diet after surgery were earlier in the DA group than in the Billroth I group(P = 0.014).Kaplan-Meier(log-rank test)analysis showed no statistically significantfive-year survival rates between the two groups at the same pathological stage..Multivariate analysis showed abnormal CEA(P = 0.006),chemotherapy(P < 0.001),T stage(P < 0.001),and N stage(P < 0.001)were independent prognosis factor for survival.Conclusions: DA and laparoscopic assisted Billroth I are feasible and safe reconstruction methods of digestive tract after gastric cancer.DA is a recommended reconstruction method for laparoscopic distal gastrectomy.