Feasibility study of uncut Roux-en-Y anastomosis in totally laparoscopic radical total gastrectomy and reconstruction of digestive tract

Objective To explore the safety and feasibility of uncut Roux-en-Y anastomosis in totally laparoscopic radical total gastrectomy and reconstruction of digestive tract. Methods The clinical data of 75 patients with gastric cancer who underwent totally laparoscopic radical total gastrectomy from June 2015 to May 2017 were retrospectively analyzed. They were divided into two groups according to different reconstruction methods of digestive tract. 37 patients in the uncut group were treated with uncut Roux-en-Y anastomosis, while 38 patients in the traditional group were treated with conventional Roux-en-Y anastomosis. Statistical software SPSS 20.0 was used for data analysis. Perioperative indicators, serum nutritional indicators and other measurement data were represented by (±s), and compared with independent t test. χ2 test or Fisher test was performed for the short and long term complications, and P<0.05 showed statistically significant difference. Results The uncut group was significantly superior to the traditional group in terms of total operation time, digestive tract reconstruction time, intraoperative blood loss, recovery of exhaust time, first feeding time and hospital stay (P<0.05). The total incidence of short-term and long-term complications in the traditional group (13.2%, 21.1%) was significantly higher than those in the uncut group (2.7%, 5.4%) (P<0.05). The short-term postoperative efficacy and bile reflux ratio of patients in the uncut group were better than those in the traditional group (P<0.05). Three months after the operation, the serum nutrition indexes of the two groups recovered gradually, and the difference between the uncut group and the traditional group was statistically significant, the former was better (P<0.05). Conclusion The uncut Roux-en-y anastomosis is safe and feasible in totally laparoscopic radical total gastrectomy and is worthy of clinical application. Key words: Anastomosis, Roux-en-Y; Laparoscopes; Gastrectomy; Gastrointestinal tract; Non-detached Roux-en-Y anastomosis