Abstract:

Application of uncut Roux-en-Y reconstruction after laparoscopic gastrectomy for distal gastric cancer: A report of 119 cases        YANG Dong, SU Tong-rong，HE Liang, et al. Department of Gastrointestinal and Anal Surgery, the First Hospital of Jilin University,Changchun 130021,China
Corresponding author: WANG Quan,E-mail：wangquanjdyy@163.com
Abstract    Objective    To analyze the application of uncut Roux-en-Y reconstruction after laparoscopic gastrectomy for distal gastric cancer. Methods    A total of 119 cases underwent uncut Roux-en-Y reconstruction after laparoscopic gastrectomy for distal gastric cancer were studied retrospectively between January 2015 and April 2016 in the First Hospital of Jilin University， and relevant clinical observation and postoperative complications were analyzed. Results The total incidence of complications was 9.7%， and the pH values of perioperative gastric juice were all less than 7.0. The efferent loop peristalsis went well without stasis or reflux， and no gastroparesis. After 6 days and 3 months，the fully emptying rates of 30 minutes were 73.1% and 82.7% respectively. In postoperative 3 months， heartburn and remnant gastritis accounted for 6.7% and 32.4%，respectively. Conclusion    Uncut Roux-en-Y effectively improves the alkaline reflux of Billroth Ⅱ and avoids Roux-en-Y stasis syndrome. So it is a safe and feasible reconstructive procedure to be applied in the clinical practice.

Key words: distal gastric cancer, laparoscopy, uncut Roux-en-Y, complication

摘要：

目的    分析腹腔镜远端胃癌根治术非离断式Roux-en-Y吻合临床特点、术后并发症分布情况。方法 回顾性分析吉林大学第一医院胃结直肠外科自2015年1月至2016年4月收治的共119例行腹腔镜远端胃癌根治术非离断式 Roux-en-Y吻合病例资料，行相关临床观察并对术后并发症进行统计学分析。结果    并发症总发生率为9.7%，围手术期胃液pH值监测均＜7.0，上消化道造影见输出袢蠕动良好，无造影剂淤滞或反流，无胃瘫综合征出现，术后6 d及3个月30 min造影剂完全排空比例分别为73.1%、82.7%；术后3个月反酸和残胃炎占比分别为6.7%和32.4%。结论    非离断式 Roux-en-Y吻合可有效地改善毕Ⅱ式吻合的碱性反流并预防Roux-en-Y淤滞综合征，是一种安全可行的消化道重建方式，建议在临床中推广。

关键词: 远端胃癌, 腹腔镜, 非离断式 Roux-en-Y吻合, 并发症