Influence of different anastomosis procedures on postoperative complications and gastrointestinal function recovery in patients undergoing radical distal gastrectomy

doi:10.3877/cma.j.issn.1674-0785.2022.10.014

Abstract

Abstract:

Objective

To investigate the influence of different anastomosis procedures on the prevention of postoperative complications and gastrointestinal function recovery in patients undergoing radical distal gastrectomy.

Methods

A total of 90 patients who underwent radical distal gastrectomy at the People's Hospital of Guangxi Zhuang Autonomous Region from January 2019 to January 2021 were retrospectively selected, of whom 49 underwent modified Billroth II gastrojejunal anastomosis + jejunal Braun anastomosis (group A) and 41 underwent Billroth II gastrojejunostomy + jejunal Braun anastomosis (group B). The postoperative complications and gastrointestinal function indexes of the two groups of patients were recorded. The changes of immune function indexes before and 3 days after operation, and the quality of life before operation, 1 month after operation, and 6 months after operation were compared between the two groups.

Results

The rate of complications was lower in group A than in group B (P＜0.05). Times to postoperative bowel movement recovery and first half-liquid intake were shorter in group A than in group B (P＜0.05). At 3 days after operation, serum IgA, IgG, and IgM were lower than those before surgery in both groups (P＜0.05), and these indexes were higher in group A than in group B (P＜0.05). At 1 month and 6 months after operation, KPS scores were higher than those before operation in both groups (P＜0.05), and the scores were higher in group A than in group B (P＜0.05).

Conclusion

Modified Billroth II gastrojejunal anastomosis + jejunal Braun anastomosis can significantly reduce postoperative complications, promote early recovery of gastrointestinal function, and improve immune function in patients undergoing radical distal gastrectomy.

Key words: Anastomosis, Radical distal gastrectomy, Postoperative complications, Gastrointestinal function

Zhou Zhu, Xiaogang Zhong, Liu Qin, Yuping Man. Influence of different anastomosis procedures on postoperative complications and gastrointestinal function recovery in patients undergoing radical distal gastrectomy[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(10): 1000-1004.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2022.10.014

https://zhlcyszz.cma-cmc.com.cn/EN/Y2022/V16/I10/1000

Figures/Tables 5

组别	例数	男性/女性	年龄（岁， $x ¯$ ±s）	肿瘤直径（cm， $x ¯$ ±s）	Ⅰ期/Ⅱ期/Ⅲ期［例（%）］	肿瘤部位［例（%）］
组别	例数	男性/女性	年龄（岁， $x ¯$ ±s）	肿瘤直径（cm， $x ¯$ ±s）	Ⅰ期/Ⅱ期/Ⅲ期［例（%）］	胃窦	胃角
A组	49	35/14	56.23±8.98	3.46±0.78	14（28.57）/20（40.82）/15（30.61）	39（79.59）	10（20.41）
B组	41	30/11	57.07±9.29	3.53±0.80	10（24.39）/20（48.78）/11（22.45）	30（73.17）	11（26.83）
t/χ²值		0.034	0.435	0.419	0.576	0.515
P值		0.854	0.665	0.676	0.750	0.473

组别	例数	男性/女性	年龄（岁， $x ¯$ ±s）	肿瘤直径（cm， $x ¯$ ±s）	Ⅰ期/Ⅱ期/Ⅲ期［例（%）］	肿瘤部位［例（%）］
组别	例数	男性/女性	年龄（岁， $x ¯$ ±s）	肿瘤直径（cm， $x ¯$ ±s）	Ⅰ期/Ⅱ期/Ⅲ期［例（%）］	胃窦	胃角
A组	49	35/14	56.23±8.98	3.46±0.78	14（28.57）/20（40.82）/15（30.61）	39（79.59）	10（20.41）
B组	41	30/11	57.07±9.29	3.53±0.80	10（24.39）/20（48.78）/11（22.45）	30（73.17）	11（26.83）
t/χ²值		0.034	0.435	0.419	0.576	0.515
P值		0.854	0.665	0.676	0.750	0.473

组别	例数	反流性胃食管炎	吻合口出血	吻合口梗阻	吻合口漏	切口感染	发生率（%）
A组	49	1	0	1	1	0	6.12
B组	41	3	1	2	3	2	26.83
χ²值	-	-	-	-	-	-	7.286
P值	-	-	-	-	-	-	0.007

组别	例数	肠蠕动恢复时间	首次进半流食时间
A组	49	2.45±0.39	4.76±0.87
B组	41	3.02±0.45	5.56±1.09
t值		6.437	3.872
P值		＜0.001	＜0.001

组别	例数	IgA		IgG		IgM
组别	例数	术前	术后3天	术前	术后3天	术前	术后3天
A组	49	1.92±0.15	1.75±0.13^a	11.23±0.86	9.95±0.80^a	1.02±0.20	0.89±0.12^a
B组	41	1.89±0.20	1.52±0.17^a	11.38±0.79	8.67±0.95^a	1.00±0.15	0.73±0.14^a
t值		0.812	7.268	0.855	6.940	0.528	5.839
P值		0.419	＜0.001	0.395	＜0.001	0.599	＜0.001

组别	例数	术前	术后1个月	术后6个月
A组	49	74.32±3.25	83.82±4.01^a	89.79±3.08^a
B组	41	73.87±2.93	78.97±3.46^a	83.24±3.17^a
t值		0.684	6.078	9.915
P值		0.496	＜0.001	＜0.001

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