Abstract：Objective: To compare the application value of pants-type anastomosis and Roux-en-Y (RY) anastomosis after total gastrectomy for gastric cancer.Methods: A total of 108 patients with gastric cancer who underwent total gastrectomy at our hospital from January 2020 to May 2023 were selected as the research subjects. They were divided into the RY anastomosis group (n=54) and the pants-type anastomosis group (n=54). Both groups underwent total gastrectomy, and the RY anastomosis group and the pants-type anastomosis group underwent digestive tract reconstruction with RY anastomosis and pants-type anastomosis after total gastrectomy for gastric cancer, respectively. The surgical indicators, postoperative complications, nutritional indicators [total protein (TP), hemoglobin (Hb), serum albumin (ALB), and prognostic nutritional index (PNI)], quality of life (QLQ-C30), and the incidence of long-term adverse events were compared between the two groups. Results: There was no significant difference in surgical indicators between the two groups (P>0.05). One case in the RY anastomosis group had the stapler replaced due to intestinal size reasons. The replacement rate of the stapler in the RY anastomosis group was higher than that in the pants-type anastomosis group, but the difference was not significant (P>0.05). The total incidence of postoperative complications in the pants-type anastomosis group was lower than that in the RY anastomosis group (P<0.05). The total incidence of long-term adverse events in the pants-type anastomosis group was lower than that in the RY anastomosis group (P<0.05). Compared with the preoperative values, the nutritional evaluation indicators TP, Hb, ALB, and PNI in both groups were increased at 3 and 6 months after surgery, and gradually increased with the extension of the postoperative time (P<0.05). The values of TP, Hb, ALB, and PNI were higher in the pants-type anastomosis group than in the RY anastomosis group at 3 and 6 months after surgery (P<0.05). Compared with the preoperative values, the QLQ-C30 scores of both groups were increased at 3 and 6 months after surgery, and gradually increased with the extension of the postoperative time (P<0.05). The QLQ-C30 scores of the pants-type anastomosis group were higher than those of the RY anastomosis group at 3 and 6 months after surgery (P<0.05). Conclusion: Compared with RY anastomosis after total gastrectomy for gastric cancer, pants-type anastomosis has a lower incidence of complications and is superior to RY anastomosis in terms of anti-bile reflux, reflux esophagitis, and food emptying disorder. Patients can obtain better nutritional support after surgery, and their quality of life is significantly improved, with higher application value.
王亮, 赵军, 汪兵, 史良会. 裤形吻合与RY吻合方式在胃癌全胃切除后的应用价值比较[J]. 河北医学, 2024, 30(3): 462-468.
WANG Liang, ZHAO Jun, WANG Bing, et al. Comparative Study of the Application Value of Pants-Type Anastomosis and Roux-en-Y Anastomosis after Total Gastrectomy for Gastric Cancer. HeBei Med, 2024, 30(3): 462-468.
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2024, Vol. 30 
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