Comparison Of Intracorporeal Uncut Roux-en-Y And Single-incision Assisted Roux-en-Y Anastomosis After Laparoscopic Gastrectomy For Gastric Cancer

Objective: We analyzed our clinical data of intracorporeal uncut Roux-en-Y reconstruction after laparoscopic gastrectomy in order to evaluate its effectiveness in terms of minimal invasiveness,technical feasibility,and safety.Methods: One hundred and thirty-eight patients with gastric cancer who underwent laparoscopic gastrectomy between November 2015 to April 2017 were retrospectively analyzed.There were 59 cases with uncut Roux-en-Y anastomosis(URY group)and 79 cases with small incision-assisted Roux-en-Y anastomosis(RY group).Postoperative outcomes were compared to indicate the differences between two different ways of digestive tract reconstruction.The data was analyzed in SPSS19.0 statistical software.Results: The mean operation time in URY group was 233.7±35.9 minutes,significantly shorten than the 256.0±44.6 minutes in the RY group(P<0.01).And the mean anastomotic time in URY group was shorten than that in the RY group(35.8vs.65.1min,P<0.01).URY group was associated with a shorter incision length(2.9 vs.6.2cm,P<0.01).URY group was associated with early flatus passage(2.1 vs.2.8d,P<0.01),earlier liquid diet intake(2.6vs.3.3d,P < 0.05),and a shorter postoperative hospital stay(8.8 vs.10.5d,P < 0.05).The morbidity of postoperative complications had no significant difference between two groups(P>0.05).In the postoperative follow-up,the Roux-en-Y stasis syndrome in URY group was significantly less frequently observed than that in RY groug(10.2% vs.26.6%,P < 0.05),and incidence of anastomotic stenosis in URY group were lower than in RY group(0 vs.10.1%,P<0.05).Conclusion: The intracorporeal uncut Roux-en-Y reconstruction after laparoscopic gastrectomy was safe and feasible,and we were able to obtain acceptable surgical outcomes in terms of minimal invasiveness and better recovery,which is worth popularizing in clinical use.