Anastomosis for distal gastrectomy in Chinese patients: uncut roux-Y or roux-Y?
Anastomosis for distal gastrectomy in Chinese patients: uncut roux-Y or roux-Y?
复制标题
中国患者远端胃切除术的吻合：未切割的roux-Y还是roux-Y？
DOI：
10.1186/s12893-019-0672-8
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发表时间：
2020-01-09
期刊：
影响因子：
1.9
通讯作者：
Zhu, Z. G.
中科院分区：
文献类型：
--
作者：
Sah, B. K.;Li, J.;Zhu, Z. G.
背景胃癌患者行胃空肠吻合术时，选择合适的吻合方法至关重要。在过去的二十年里，外科医生提出了不同类型的改良胃空肠吻合术。我们关注两种标准吻合术，即，Uncut Roux-Y和Roux-Y胃空肠吻合术，并比较两种types.MethodsThis的术后即刻并发症的差异是一个回顾性研究236例胃癌患者进行根治性远端胃切除术与胃空肠Roux-Y或Uncut Roux-Y吻合术连续6年。比较两组术后即刻并发症。作者讨论了显着并发症的原因和他们的management.ResultsThere是两组（92 Roux-y与144未切割Roux-y）之间的人口统计学没有差异。未切割Roux-Y组的总体并发症发生率为20.8%，吻合口瘘发生率为1.4%，Roux-Y组的总体并发症发生率为33.7%，吻合口失败发生率为7.6%（p< 0.05）。Roux-Y吻合组腹腔感染发生率高于非切割Roux-Y吻合组（p< 0.05）。Roux-Y吻合组术后住院时间明显长于Roux-Y吻合组（p< 0.05）。在多中心随机对照试验中，一个设计良好的大型队列是必要的，以支持这些发现和比较其他方面。
BackgroundAn appropriate method of anastomosis is crucial for gastric cancer patients who require gastrojejunal anastomosis. Surgeons have proposed different types of modified gastrojejunostomies in the last two decades. We focused on two types of standard anastomosis, i.e., Uncut Roux-Y and Roux-Y gastrojejunostomies, and compared the differences in immediate postoperative complications between the two types.MethodsThis is a retrospective study on 236 gastric cancer patients who underwent curative distal gastrectomy with gastrojejunal Roux-Y or Uncut Roux-Y anastomosis for six consecutive years. Immediate postoperative complications were compared between the two groups. The authors discussed the causes of the significant complications and their management.ResultsThere was no difference in demographics between the two groups (92 Roux-y Versus 144 Uncut Roux-y). The overall complication rate was 20.8% with 1.4% anastomotic leakage in the Uncut Roux-Y group versus 33.7% with 7.6% anastomotic failures in the Roux-Y group (p< 0.05). More abdominal infections occurred in the Roux-Y anastomosis group compared with the Uncut Roux-Y anastomosis group (p< 0.05). Duration of postoperative stay was significantly longer in patients with Roux-y anastomosis group (p< 0.05).ConclusionsConsidering the surgical simplicity and postoperative complications, the Uncut Roux-Y is a better choice for anastomosis in patients with gastric cancer undergoing gastrojejunostomy. A well-designed large cohort in a multi-centre randomized controlled trial is necessary to support these findings and compare other aspects.