Application Of Overlap Anastomosis In Billroth Type Ⅰ Digestive Tract Reconstruction For Laparoscopic Distal Gastrectomy For Gastric Cancer

Objective:To evaluate the clinical value of laparoscopic Overlap anastomosis in BillrothⅠ digestive tract reconstruction after laparoscopic distal gastrectomy in gastric cancer.Methods:The data of 75 cases of gastric cancer patients received laparoscopic distal gastrectomy from June 2016 to December 2018 at China-Japan Union Hospital of Jilin University were retrospectively analyzed.Among them,35 cases of overlap anastomosis group and 40 cases of traditional BillrothⅠ anastomosis group(two groups were operated by the same surgeon),and the therapeutic effects of two groups were compared.Results:The two groups completed laparoscopic surgery without conversion to open surgery.Compared to BillrothⅠ anastomosis group,the Overlap anastomosis group has shorter anastomotic time of digestive tract reconstruction and operation time[(31.6±5.3)min vs(38.7±7.2)min,t=4.858,P<0.001],[(180.5±17.8)min vs(195.8±16.6)min,t=3.961,P<0.001],shorter abdominal incision length [(5 ± 0.8)cm vs(11.5 ± 2.4)cm,t=15.378,P<0.001],shorter time to flatus [(4.1± 1.3)d vs(5.6±1.2)d,t=4.825,P<0.001]and postoperative hospitalization[(12.1 ± 1.9)d vs(14.9 ± 1.6)d,t=7.010,P<0.001].There were no statistical differences in intraoperative blood loss,number of lymph node dissected,morbidity of postoperative complication and hospitalization expenses.All the patients were followed up for(12-50)months.There were no long-term complications,recurrence or death in the two groups.Conclusion:Overlap anastomosis in BillrothⅠ digestive tract reconstruction after laparoscopic distal gastrectomy is safe and effective.It is worth popularizing.