1. Isoperistaltic versus antiperistaltic uncut Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a propensity score matched analysis
- Author
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Luo Tianhang, Huang Huabing, Yin Xiaoyi, Cui Hangtian, and Fang Guo-en
- Subjects
Male ,medicine.medical_specialty ,Distal gastrectomy ,lcsh:Surgery ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Gastrectomy ,Stomach Neoplasms ,Uncut Roux-en-Y anastomosis ,Propensity score matching ,Humans ,Medicine ,Propensity Score ,business.industry ,Cancer ,Anastomosis, Roux-en-Y ,lcsh:RD1-811 ,General Medicine ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Laparoscopy ,Peristalsis ,030211 gastroenterology & hepatology ,Gastritis ,medicine.symptom ,business ,Ligation ,Research Article - Abstract
Background The uncut Roux-en-y anastomosis (URYA) has some clinical advantages after distal gastrectomy (DG). Little evidence exists regarding the influence of peristalsis on this anastomosis. We aimed to evaluate short-term outcomes of isoperistaltic URYA (iso-URYA) comparing with antiperistaltic URYA (anti-URYA) after DG. Method Patients who underwent URYA for gastric cancer (GC) between January 2016 and December 2018 were selected from Shanghai Changhai Hospital, Navy Medical University. Short-term outcomes were compared between iso-URYA group and anti-URYA group after 1:1 propensity score matching (PSM). Result A total of 612 patients were selected. 392 patients underwent iso-URYA and 220 patients underwent anti-URYA. After PSM, 183 patients for each group were included in the final analysis. No differences were found between them in terms of short-term complications, nutritional status and quality of life 1 year after surgery. Endoscopic examination showed that anti-URYA group had more severe gastritis (P = 0.036). In addition, the recanalization rate was significantly higher when the afferent loop was blocked by stapler. Conclusion The iso-URYA and anti-URYA group present similar results in short term outcomes. Ligation blocking afferent loop leads to lower recanalization rate.
- Published
- 2020