Comparison among three reconstruction techniques after distal radical gastrectomy

Objective To compare surgical efficacy after three different reconstruction techniques after radical resection of distal gastric cancer.Methods Clinical data of 169 cases of distal gastric cancer operated in our hospital from 2007 to 2010 were retrospectively analyzed.The reconstruction techniques included Billroth Ⅰ anastomosis (n=60),Billroth Ⅱ anastomosis (n =41 ),and Roux-en-Y anastomosis (n=68).Efficacy among 3 groups was compared.Specific synptoms scale was used to evaluate the quality of life in three methods after three months.Results Compared to Billroth Ⅰ anastomosis and Billroth Ⅱ anastomosis,Roux-en-Y anastomosis had longer operative time[ (266.3±70.4) min vs.(196.2±54.3) min,and (228.5±67.7) min],more blood loss[(220.9±67.6) ml vs.(170.5±61.5) ml and (188.5±76.7) ml],and shorter time to gastric tube removal [(2.6±1.5) d vs.(3.1±1.3) d and (3.6±1.2) d],milder postoperative reflux and heartburn sensation (specific symptoms scale,1.8±0.4 vs.1.9±0.6 and 2.6±0.4,P＜0.05).Conclusions Although Roux-en-Y anastomosis is not consistent with physiological route and the procedure is more complex to perform,it can effectively prevent reflux complications.Roux-en-Y anastomosis is a better reconstruction technique after radical resection of distal gastric cancer. Key words: Stomach neoplasms;  Distal subtotal gastrectomy;  Digestive tract reconstruction; Quality of life