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. 2020 Jan 9;20(1):7.
doi: 10.1186/s12893-019-0672-8.

Anastomosis for distal gastrectomy in Chinese patients: uncut roux-Y or roux-Y?

B K Sah  1 , J Li  2 , C Yan  3 , C Li  4 , M Yan  4 , Z G Zhu  4
Affiliations

Anastomosis for distal gastrectomy in Chinese patients: uncut roux-Y or roux-Y?

B K Sah et al. BMC Surg. .

Abstract

Background: An appropriate method of anastomosis is crucial for gastric cancer patients who require gastrojejunal anastomosis. Surgeons have proposed different types of modified gastrojejunostomies in the last two decades. We focused on two types of standard anastomosis, i.e., Uncut Roux-Y and Roux-Y gastrojejunostomies, and compared the differences in immediate postoperative complications between the two types.

Methods: This is a retrospective study on 236 gastric cancer patients who underwent curative distal gastrectomy with gastrojejunal Roux-Y or Uncut Roux-Y anastomosis for six consecutive years. Immediate postoperative complications were compared between the two groups. The authors discussed the causes of the significant complications and their management.

Results: There was no difference in demographics between the two groups (92 Roux-y Versus 144 Uncut Roux-y). The overall complication rate was 20.8% with 1.4% anastomotic leakage in the Uncut Roux-Y group versus 33.7% with 7.6% anastomotic failures in the Roux-Y group (p < 0.05). More abdominal infections occurred in the Roux-Y anastomosis group compared with the Uncut Roux-Y anastomosis group (p < 0.05). Duration of postoperative stay was significantly longer in patients with Roux-y anastomosis group (p < 0.05).

Conclusions: Considering the surgical simplicity and postoperative complications, the Uncut Roux-Y is a better choice for anastomosis in patients with gastric cancer undergoing gastrojejunostomy. A well-designed large cohort in a multi-centre randomized controlled trial is necessary to support these findings and compare other aspects.

Keywords: Gastric cancer gastrojejunostomy; Roux-Y; Uncut roux-Y.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Typical Roux-Y gastrojejunostomy
Fig. 2
Fig. 2
Uncut Roux-Y gastrojejunostomy
Fig. 3
Fig. 3
Difference of Postoperative stays at hospital
See this image and copyright information in PMC

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