Clinical observation of postoperative reflux and nutritional recovery of patients after radical proximal gastric cancer resection by using two different anastomosis procedures

Objective To investigate the clinical outcome of two different anastomosis procedures on postoperative reflux and nutritional recovery of patients after radical operation for proximal gastric cancer. Methods Retrospective analysis of clinical data were performed in 60 patients with gastric cancer who underwent proximal radical gastrectomy from January 2015 to October 2017. The patients were divided into anterior wall anastomosis group (n=30) and posterior wall anastomosis group (n=30) according to different anastomotic methods. SPSS 19.0 software was used to analyze the data. Measurement data such as nutritional indicators, scores of Visick and gastroscopic reflux esophagitis were expressed as mean±standard deviation and were examined by independent t test. Count data such as the incidence of postoperative complications were described by (n, %) and were examined by chi square test. Grade data were examined by using mann-whitney U test. A P value of <0.05 was considered as statistically significant. Results The operation time of anterior wall anastomosis group was slightly longer than that of posterior wall anastomosis group (P<0.05). By using anterior wall anastomosis, Visick and gastroscope under reflux esophagitis scores were significantly lower than those in posterior wall anastomosis group on 3 months, 6 months after operation respectively (P<0.05), while Hb, Alb, PNI, PG Ⅰ were significantly higher (P<0.05). Conclusion Compared with posterior wall anastomosis, the application of gastroesophageal anterior wall anastomosis in radical operation for proximal gastric cancer could play a better anti-reflux role, which is more conducive to the recovery of residual stomach function, thus improving the nutritional status of patients. Key words: Stomach neoplasms; Gastrectomy; Esophagogastric junction; Comparative effectiveness research