| Objective:To evaluate the surgical value of Billroth Ⅱ+Braun anastomosis in laparoscopic assisted radical gastrectomy for distal gastric cancer.Methods:The data of patients who underwent laparoscopic assisted radical gastrectomy for distal gastric cancer in Gastrointestinal Surgery department of Jiangxi Provincial People’s Hospital from June 2015 to June 2017 were retrospectively analyzed.A total of 93 patients were enrolled in this study,and were divided into Billroth Ⅱ combined with Braun anastomosis group and Billroth Ⅱ anastomosis group according to different methods of digestive tract reconstruction.There were 45 cases in Billroth Ⅱ+ Braun anastomosis group and 48 cases in Billroth Ⅱ anastomosis group.General perioperative data 、 postoperative complications 、 survival rate and other data of subjects in the two groups were collected,and statistical analysis was conducted by SPSS25.0 statistical software(test level: α=0.05).Results:Comparison of short-term efficacy: the average operation time and cost,total hospitalization costs of the Billroth Ⅱ+Braun anastomosis group were higher than those of the Billroth Ⅱ anastomosis group,and the differences were statistically significant(P<0.05).And two groups of intraoperative blood loss,anal exhaust time,indwelling drainage tube time,average length of hospital stay,Number of dissected lymph nodes,the incidence of postoperative infection of incision,incidence,the incidence of gastric paralysis,incidence of duodenal stump leakage and incidence of pulmonary infection had no statistical difference(P > 0.05).Comparison of long-term efficacy: the bile reflux rate,the incidence of reflux gastritis and reflux esophagitis in the Billroth Ⅱ+Braun anastomosis group were lower than those in the Billroth Ⅱ anastomosis group,and the differences were statistically significant(P<0.05).There were no significant differences in the completion rate of gastroscopy,incidence and severity of anemia,Visick grade,BMI and survival rate between the two groups within one year(P>0.05).Conclusion:Billroth Ⅱ + Braun anastomosis and Billroth Ⅱ anastomosis are equally safe and effective in radical gastrectomy for distal gastric cancer,and can achieve similar quality of life and survival rate.Increased Braun anastomosis did not significantly increase the difficulty of surgery,and it can reduce the complications caused by alkaline intestinal reflux to a certain extent,but more evidence is needed to support it.Braun anastomosis showed no significant advantage in preventing other postoperative complications. |
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