[Use of uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer].

Objective To evaluate the clinical efficacy of uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer. Methods Clinical data of 419 patients who underwent distal gastrectomy for gastric cancer with complete follow-up data between March 2005 and March 2008 in the Cancer Institute and Hospital of Tianjin Medical University. Patients were divided into B I (138 cases with Billroth I reconstruction), M-B II (108 cases with modified Billroth II reconstruction), RY(46 cases with Roux-en-Y reconstruction) and Uncut RY(127 cases with uncut Roux-en-Y reconstruction) according to reconstructive methods. Results Patients in the Uncut RY group had a larger tumor diameter, more T3, and poorer stage of disease compared to those in the B I (P<0.05). In Uncut RY group, the operative time and postoperative hospital stay were (132.6±9.2) minutes and (10.4±1.2) days respectively,shorter than those in RY group (142.5±1.7) minutes and (12.1±3.7) days (both P<0.05), alkaline reflex gastritis rate was 3.2%, lower than that in B I group (24.6%, P<0.05) and M-B II group (25.9%,P<0.05). Marginal ulcer rate in uncut RY group was lower compared to M-B II group (P=0.019), and incidence of Roux-en-Y stasis syndrome was less compared to RY group (P=0.000). Conclusions The uncut Roux-en-Y reconstruction is both feasible and safe. It can prevent alkaline reflex gastritis and Roux-en-Y stasis syndrome. It may be the preferred technique for reconstruction after distal gastrectomy. Key words: Stomach neoplasms,distal; Gastrectomy; Digestive tract reconstruction,uncut Roux-en-Y reconstraction; Reflex gastritis; Roux-en-Y stasis