Researches On Clinical Applicationvalue Of Jejunal Interposition After Radical Proximal Gastrectomy

Objective: To compare the differences of jejunal interposition for proximal gastric cancer patients undergone digestive tract reconstruction after radical proximal gastrectomy with the traditional Gastroesophagostomy,which was about different aspects of operation safety,anti-reflux effect,prevention of reflux esophagitis,nutritional,status,postoperative quality of life and others,to assess the clinical application value of jejunal interposition after radical proximal gastrectomy.Methods:A total of 91 patients with gastric cancer confirmed by endoscopy and selected from Gastrointestinal Department of surgery in Affiliated Hospital of Yan'an University from june 2015 to December 2016,those were randomly divided into two groups.In experimental group(group JI),45 patients undergone jejunal interposition in the digestive tract reconstruction methods of radical proximal gastrectomy;In the control group(group EG),46 patients undergone the traditional gastroesophagostomy.Recording of two groups of patients with operation time,bleeding volume during operation,perioperative complications,reflux symptoms score,endoscopic examination of the lower esophagus mucosa and changes in the classification of the indicators,using of statistical software to analyze the results,to understand whether had differences or not.Results:The jejunal interposition group(group JI)compared with the traditional Gastroesophagostomy group(group EG)at the operation time(group JI,159.9±17 min;group EG,118.2±19.6min)were longer,P<0.05,there was statistically significant differences.There were no significant differences of the volume of bleeding(group JI,160.2±23.1 ml;group EG,153.5±29.3ml),in postoperative 2-,4-,6-day,the incidence rate of SIRS and the changes of CRP,intraperitoneal hemorrhage,anastomotic fistula and other perioperative complications,P>0.05,the difference was not statistically significant.Postopera-tive 3-,6-month,to assess the scores of changes for patients' s weight,the score of reflux symptoms and the changes of prealbumin;Postoperative 6-month,the inflammatory changes of esophageal mucosa under gastroscope and gastroscope gastric juice and the grade of pathological biopsy;The above results were statistically analyzed,P<0.05,the results were statistically significant.Conclusion: 1.Proximal gastric cancer in the premise of satisfying radical underwent inthe digestive tract reconstruction methods of radical proximal gastrectomy compared with traditional Gastroesophagostomy requiring to relatively extend operation time,but there was no significantly statistical difference in perioperative safety between them;2.In the treatment of proximal gastric cancer,choosing the reconstruction of digestive tract of jejunal,the incidence of reflux esophagitis was low and the quality of life was significantly improved.