[Prevention of closure point recanalization after uncut Roux-en-Y anastomosis for radical resection of distal gastric cancer]

Abstract

Uncut Roux-en-Y anastomosis is widely used in gastrointestinal reconstruction procedure after radical gastrectomy for distal gastric cancer. However, the proximal jejunal closure point recanalization of the input loop is an important complication of postoperative patients with prolonged time, resulting in pancreatic juice or bile reflux, which can lead to inflammatory lesions of the remnant stomach or esophagus. Poor selection of the location of the closure point during anastomosis causes a large amount of food deposited in the blind loop to be pushed and impacted, resulting in loosened threads or failed U-shaped staples, which may cause recanalization complications. Most scholars believe that the shortening of the jejunal tube closure point to the optimal position of 2 to 3 cm from the residual gastrojejunostomy can significantly reduce food retention, decrease the pressure of the closure point and the incidence of recanalization. At present, the application of new anastomotic techniques and materials such as four-row and six-row U-shaped staples and 7# wire ligation under laparoscopy can prevent the occurrence of recanalization of the closure point. Uncut Roux-en-Y anastomosis is safe and has few complications, and is expected to become one of the best ways of digestive tract reconstruction.

Keywords: Radical surgery for distal gastric cancer; Recanalization of closed point; Stomach neoplasms; Uncut Roux-en-Y anastomosis.