Abstract: Analysis of the safety and efficacy of Billroth I-ART anastomosis in totally laparoscopic distal radical gastrectomy        ZHANG Hai-qiao, ZHENG Zhi, LIU Xiao-ye, et al. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
Corresponding authors：ZHANG Jun, E-mail:zhangjun5986@ccmu.edu.cn; YIN Jie, E-mail:yyyyyj@ccmu.edu.cn
Abstract    Objective    To explore the safety and short-term efficacy of Billroth I-ART anastomosis in totally laparoscopic distal radical gastrectomy. Methods    The clinical data and follow-up data of 81 patients with primary gastric cancer who underwent laparoscopic ART anastomosis were retrospectively analyzed. Results    The operation time was（226.2±46.4）minutes，the anastomotic time was（11.7±3.6）min，and the intraoperative blood loss was 50（QR=50）mL. All patients underwent R0 resection.The first time to get out of bed is 1（QR=1） d，time to pass gas was 3（QR=1.5） d，time to remove the gastric tube was 2（QR=2） d，time to oral intake was 3（QR=1） d，time to liquid food intake was 5（QR=2） d，and the postoperative hospital stay was 7（QR=1） d. There were no severe complications and death within 30 days after surgery.In the follow-up results，the incidence of dumping syndrome and reflux symptoms at 6 months after surgery was 6.25% and 16.25%，respectively.In the EORTC QLQ-C30 and QLQ-STO22 questionnaires，emotional and social functioning  were inferior to other functional scales. Fatigue diarrhea，financial difficulties，and anxiety were low to other symptom scales.In the 1-year follow-up，the incidence rates were 52.3% for gastritis，15.9% for anastomotic stomatitis，6.8% for reflux esophagitis，6.8% for bile reflux，and 15.9% for gastric retention. Conclusion    Total laparoscopic ART anastomosis is safe and feasible，and has achieved good results in anastomotic complications and short-term efficacy.

Key words: stomach tumor, surgical methods, Billroth I-ART anastomosis, quality of life

摘要： 目的    探究全腹腔镜远端胃癌根治术Billroth Ⅰ-ART吻合的安全性及术后近期疗效。方法    回顾性分析首都医科大学附属北京友谊医院81例原发性胃癌病人行全腹腔镜ART吻合的临床资料及随访资料。结果  手术时间（226.2±46.4）min，吻合时间（11.7±3.6）min，术中出血量50［四分位数间距（QR）=50］mL，所有病人均R0切除。首次下床时间1（1）d，首次排气时间为3（QR=1.5）d，拔除胃管时间2（QR=2）d，首次进食时间3（QR=1）d，首次进流食时间5（QR=2）d，术后住院时间7（QR=1）d。术后30 d内无严重并发症及死亡。随访结果中，术后6个月的倾倒综合征发生率为6.25%，反流症状发生率为16.25%。在EORTC QLQ-C30及QLQ-STO22量表中，情绪和社会功能与其他功能领域相比较差，疲劳、腹泻、经济困难、焦虑与其他症状领域相比较差。术后1年随访中，胃炎占52.3%，吻合口炎占15.9%，反流性食管炎占6.8%，胆汁反流占6.8%，胃潴留占15.9%。结论    全腹腔镜ART吻合是安全可行的，在吻合口相关并发症和近期疗效方面结果显著。

关键词: 胃肿瘤, 手术方式, Billroth I-ART吻合, 生活质量