Effect Of Different Digestive Tract Reconstruction On Blood Glucose Of Gastric Cancer Complicated With T2DM

BackgroundGastric cancer and diabetes have been a serious threat to human health for a long time.China has gradually become a country with both gastric cancer and diabetes.With the development of urbanization and the aging of the population,more and more patients in China suffer from both gastric cancer and type 2 diabetes(T2DM),and the number is increasing year by year.Surgery treatment is the core of the comprehensive treatment aboout gastric cancer,which can improve the overall survival in patients with gastric cancer,for those with T2DM patients with gastric cancer,can adopt the method of surgery,and at the same time can play a dual role of gastric cancer effect a radical cure and control blood sugar,at this point,more and more become a hot spot of the current surgical,so in many surgery,to find the best procedure for two kinds of disease treatment effect is particularly critical.AimIn this paper,the retrospective observation method was used to analyze and compare the effects of Billroth II Gastrojejunostomy,Roux-en-Yesophagojejunostomyand Roux-en-Y gastrojejunostomy on postoperative blood glucose and body weight in patients with gastric cancer complicated with diabetes,and to explore the hypoglycemic mechanism of each operation,which can provide a basis for the treatment of gastric cancer patients with diabetes.The data of 45 patients with gastric cancer complicated with T2DM diagnosed by pathology in the Department of Gastrointestinal surgery of the Hospital of Chenzhou affiliated to University of South China from January 2017 to January 2020 were collected.They were divided into 3 groups according to different surgical methods.Group A(Roux-en-Y esophagojejunostomy group)11 cases,accounting for 24.4%of(Billroth II gastrojejunostomy group B group)19 cases,accounting for42.4%Magi C group(Roux-en-Y gastrojejunostomy group)15 cases,accounting for 33.3%,25 males,20 females,age(62.84±5.26)years old,height(164.18±8.91)cm,preoperative weight(65.02±8.61)kg,preoperative Body Mass Index(BMI)(24.14±2.73)kg/m~2.Preoperative Fasting Plasma Glucose(FPG)(9.62±1.18)mmol/L,preoperative 2-hour Postprandial Blood Glucose(2h PG)(12.86±1.69)mmol/L,preoperative Glicated Hemoglobin A1c(Hb A1c)(7.84±1.50)%,all patients were examined routinely,such as routine examination,electrocardiogram,blood biochemistry,chest and abdomen CT Serum C-Peptide FPG 2h PG Hb A1c and BMI.SPSS24.0 statistical software was used for statistical analysis,and the changes of FPG 2h PG BMI and Hb A1c of the three groups of patients with ABC before operation,3 months and 6 months after operation were compared,and the remission rates of different operations for diabetes were obtained.ResultNo statistically significant differences in the basic characteristics of the three groups of patients in age gender weight hight BMI FPG 2h PG and Hb A1c(P>0.05),and they were comparable.All these gastrointestinal reconstruction surgery can reduce the blood sugar and BMI of patients with gastric cancer and T2DM(P<0.05).In reducing the levels of FPG,2h PG and Hb A1c,group B(Billroth II gastrojejunostomy group)had the worst effect(P<0.05),and group C(Roux-en-Y gastrojejunostomy group)had the best effect(P<0.05)),A group(Roux-en-Y esophageal jejunal anastomosis group)had a moderate effect(P<0.05).The three surgical procedures could reduce the patient’s body mass index BMI(P<0.05),and no difference at the same time point Statistically significant(P>0.05),the difference in the efficacy of the three surgical procedures in type 2 diabetes is statistically significant(P<0.05).After pairwise comparison,the C group(Roux-en-Y gastrojejunal Anastomosis group)is better than the other two groups in the treatment of T2DM,group A(Roux-en-Y esophagojejunostomy group)followed by group B(Billroth II gastrojejunostomy group)has the worst effect.ConclusionSurgery treatment of gastric cancer with T2DM can control blood and BMI.Billroth II gastrojejunostomy,Roux-en-Y esophagojejunostomy,Roux-en-Y gastrojejunostomy also can improve the BMI and blood glucose of patients with gastric cancer complicated with T2DM,which can relieve and cure T2DM.Among them,patients who underwent Roux-en-Y gastrojejunal anastomosis had significant postoperative blood glucose and Hb A1c control,and were even better in blood glucose control and the remission rate of type 2 diabetes.