A Comparative Study On The Short-term Clinical Efficacy Of Side-to-side And End-to-side Anastomosis After Radical Distal Gastrectomy

Objective: The aim of this study was to compare the short-term clinical differences between gastro-jejunal side-to-side and end-to-side anastomosis in the treatment of distal gastric cancer.Methods: Retrospectively analyze the clinical data of patients who underwent open radical distal gastrectomy during the same period from January 2013 to December 2019 in the Department of General Surgery,Zhongda Hospital,Southeast University.They were divided into end-to-side group and side-to-side group according to the gastric-jejunal anastomosis,The differences in general conditions,operation time,bleeding volume,anal exhaust time,postoperative complications,length of hospital stay,and total costs were compared between the two groups.Results: A total of 175 cases included in this study were successfully completed radical distal gastrectomy(D2 lymph node dissection)and gastrointestinal reconstruction.There was no statistically significant difference in the general data of the two groups such as age,gender,BMI,etc.(P>0.05);The operation time,bleeding volume,postoperative anastomotic complications(non-gastric paralysis),other complications(infection,circulatory respiratory system,urinary related)and total costs were not statistically different(P> 0.05);Postoperative gastroparesis syndrome occurred in 26 patients(15%),including 6 cases(8%)in the side-to-side anastomosis group and 20 cases(20%)in the end-to-side anastomosis group(P<0.05);The median hospital stay in the side-to-side anastomosis group was 18(15,21),and the side-to-side anastomosis group was19(16,24)(P<0.05);Compared with circular stapler,linear stapler in side-to-side anastomosis group had less bleeding and more positive lymph nodes were dissected(P<0.05).Conclusion: Gastro-jejunum side-to-side anastomosis can reduce the risk of postoperative gastroparesis syndrome after radical distal gastrectomy and shorten the length of hospital stay.Linear stapler is easy to operate and may avoid anastomosis-related complications.