Comparison of uncut Roux-en-Y anastomosis and traditional Roux-en-Y anastomosis in the totally laparoscopic distal gastrectomy for gastric cancer: An analysis of multiple centers’ data

Objective To compare the security and short-term effect of the digestive tract reconstruction during the totally laparoscopic distal gastrectomy for gastric cancer between the Uncut Roux-en-Y anastomosis and the traditional Roux- en- Y anastomosis. Methods The clinical data of 60 gastric cancer patients with digestive reconstruction underwent totally laparoscopic distal gastrectomy between December 2012 and June 2015 in 10 domestic hospital were analyzed retrospectively. According to the difference of digestive reconstruction,it can be divided into the Uncut Rouxen-Y anastomosis group with 34 patients and the traditional Roux-en-Y anastomosis group with 26 patients. Results In uncut Roux-en-Y anastomosis group,the operative time in digestive reconstruction was shorter[(51.5±13.3)min vs.(80.4±16.2)min,P=0.000]; the intraoperative blood loss was less[(60.0±35.6)m L vs.(132.9±65.1)m L,P=0.000];semi-liquid diet time was earlier[(4.6±1.5)d vs.(7.2±2.3)d,P=0.000]. However,there was no difference between the two groups on nasogastric tubegastrointestinaltwo groups on nasogastric tube,gastrointestinal transit,fluid diet and the duration of postoperative hospital stay. Both groups had no death case during the perioperative period and there was no significant statistical difference in the postoperative complication rates(8.8% vs. 7.7%,P=0.875).Conclusion The Uncut Roux- en- Y anastomosis and the traditional Roux-en-Y anastomosis are both safe and feasible for the digestive reconstruction under the totally laparoscopic distal gastrectomy for gastric cancer. Besides,the Uncut Roux- en- Yanastomosis has other advantages such as less reconstruction time and less bleeding.