Early Clinical Study And Comparison Of Two Kinds Of Tract Reconstruction After Total Gastrectomy

Objective To compare early clinical effect of the two kinds of reconstructionafter the total gastrectomy and discuss more reasonable way of reconstructionfor improving life quality of postoperative patients。Methods From2004to2011，101patients underwent gastrectomy and tractreconstruction at Department of General surgery of Ningxia medical universitygeneral hospital were analysed in the study， Two types of digestivereconstruction were performed in those cases，According to reconstructiontypes，there were divided into two groups：A group(45cases)， Lahey+Braun’sanastomosis；B group(56cases)，esophageal jejunal Roux-en-Y anastomosis.The clinical data，including Early postoperative complications and commonsymptoms，operation time and recovery time，nutritional status，commoncomplications and visick score after3months and6months，were comparedbetween the two groups。Results Two kinds of digestive reconstructive after total gastrectomy werenot significant differences in early complications，the operative time andpostoperative recovery of bowel function；anastomosis stricture and anemia is nostatistical differences in3months and6months； The reflux esoPhagitis anddumping syndrome in3months were not statistical significant differences，butthey were significant differences in six months(P<0.05)， in prevention of refluxesoPhagitis and dumping syndrome，Roux-en-y anastomosis was better thanLahey anastomosis； Appetite， early full disease， diarrhea and vomiting disease were not significant differences in two groups in3months and6months，but in abdominal distension，Roux-en-y anastomosis is significantly lower thanLahey anastomosis (P<0.05)；the nutrition is no statistical difference in3months,but in6months，nutrition in Roux-en-y anastomosis is significantly better thanLahey anastomosis (P<0.05)，Both in3months and6months， postoperativenutrition index (PNI) of Roux-en-y anastomosis was significantly better thanLahey anastomosis (P<0.05)； compared with Lahey anastomosis，Roux-en-yanastomosis were not significant differences in1~2level and3~4level score in3months， but in6months there were statistical differences (P<0.05)，Roux-en-y anastomosis was better than Lahey anastomosis in qualityof life in six months。Conclusion (1).Esophageal jejunal Roux-en-Y anastomosis is better thanLahey+Braun’s anastomosis in later (6months) nutritional status andprevention in the reflux esophagitis and dumping syndrome。(2).Related toLahey+Braun’s anastomosis，esophageal jejunal Roux-en-Y anastomosis is theideal tract reconstruction。...