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Comparative Study
. 2017 Oct 21;23(39):7129-7138.
doi: 10.3748/wjg.v23.i39.7129.

Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life

Ze-Ning Huang  1 , Chang-Ming Huang  2 , Chao-Hui Zheng  1 , Ping Li  1 , Jian-Wei Xie  1 , Jia-Bin Wang  1 , Jian-Xian Lin  1 , Jun Lu  1 , Qi-Yue Chen  1 , Long-Long Cao  1 , Mi Lin  1 , Ru-Hong Tu  1 , Ju-Li Lin  1
Affiliations
Comparative Study

Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life

Ze-Ning Huang et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the short-term outcomes and quality of life (QoL) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG).

Methods: A total of 507 patients who underwent laparoscopic gastrectomy (D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG (group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy (LATG) (group A, n = 456). The short-term outcomes and QoL were compared between the two groups after 1:2 propensity-score matching (PSM). We used a questionnaire to assess QoL.

Results: Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups (P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A (P < 0.05). After matching, group T reported better QoL in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better QoL ("Have you felt pain" and "Have you had difficulty eating solid food") (P < 0.05).

Conclusion: The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving QoL after laparoscopic gastrectomy.

Keywords: Esophagojejunostomy; Later-cut; Overlap; Quality of life; Totally laparoscopic total gastrectomy.

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Conflict of interest statement

Conflict-of-interest statement: We have no financial relationships to disclose.

Figures

Figure 1
Figure 1
The flow chart of patient selection. LTG: Laparoscopic total gastrectomy; TLTG: Totally laparoscopic total gastrectomy; LATG: Laparoscopic assisted total gastrectomy.
Figure 2
Figure 2
The schematic diagram of anastomosis.
Figure 3
Figure 3
The functional scales. A: EORTC-QLQ-C30; B: EORTC-QLQ-C30 and EORTC-QLQ-STO22. aP < 0.05, EORTC-QLQ-C30 vs EORTC-QLQ-STO22.
See this image and copyright information in PMC

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