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Meta-Analysis
. 2024 Feb 29;2(2):CD015014.
doi: 10.1002/14651858.CD015014.pub2.

Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer

Zhaolun Cai  1   2   3 , Mingchun Mu  1   2 , Qin Ma  4 , Chunyu Liu  5 , Zhiyuan Jiang  6 , Baike Liu  1   2 , Gang Ji  7 , Bo Zhang  1   2   3
Affiliations
Meta-Analysis

Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer

Zhaolun Cai et al. Cochrane Database Syst Rev. .

Abstract

Background: Choosing an optimal reconstruction method is pivotal for patients with gastric cancer undergoing distal gastrectomy. The uncut Roux-en-Y reconstruction, a variant of the conventional Roux-en-Y approach (or variant of the Billroth II reconstruction), employs uncut devices to occlude the afferent loop of the jejunum. This modification is designed to mitigate postgastrectomy syndrome and enhance long-term functional outcomes. However, the comparative benefits and potential harms of this approach compared to other reconstruction techniques remain a topic of debate.

Objectives: To assess the benefits and harms of uncut Roux-en-Y reconstruction after distal gastrectomy in patients with gastric cancer.

Search methods: We searched CENTRAL, PubMed, Embase, WanFang Data, China National Knowledge Infrastructure, and clinical trial registries for published and unpublished trials up to November 2023. We also manually reviewed references from relevant systematic reviews identified by our search. We did not impose any language restrictions.

Selection criteria: We included randomised controlled trials (RCTs) and quasi-RCTs comparing uncut Roux-en-Y reconstruction versus other reconstructions after distal gastrectomy for gastric cancer. The comparison groups encompassed other reconstructions such as Billroth I, Billroth II (with or without Braun anastomosis), and Roux-en-Y reconstruction.

Data collection and analysis: We used standard Cochrane methodological procedures. The critical outcomes included health-related quality of life at least six months after surgery, major postoperative complications within 30 days after surgery according to the Clavien-Dindo Classification (grades III to V), anastomotic leakage within 30 days, changes in body weight (kg) at least six months after surgery, and incidence of bile reflux, remnant gastritis, and oesophagitis at least six months after surgery. We used the GRADE approach to evaluate the certainty of the evidence.

Main results: We identified eight trials, including 1167 participants, which contributed data to our meta-analyses. These trials were exclusively conducted in East Asian countries, predominantly in China. The studies varied in the types of uncut devices used, ranging from 2- to 6-row linear staplers to suture lines. The follow-up periods for long-term outcomes spanned from 3 months to 42 months, with most studies focusing on a 6- to 12-month range. We rated the certainty of evidence from low to very low. Uncut Roux-en-Y reconstruction versus Billroth II reconstruction In the realm of surgical complications, very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Billroth II reconstruction may make little to no difference to major postoperative complications (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.24 to 4.05; I² = 0%; risk difference (RD) 0.00, 95% CI -0.04 to 0.04; I² = 0%; 2 studies, 282 participants; very low-certainty evidence) and incidence of anastomotic leakage (RR 0.64, 95% CI 0.29 to 1.44; I² not applicable; RD -0.00, 95% CI -0.03 to 0.02; I² = 32%; 3 studies, 615 participants; very low-certainty evidence). We are very uncertain about these results. Focusing on long-term outcomes, low- to very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Billroth II reconstruction may make little to no difference to changes in body weight (mean difference (MD) 0.04 kg, 95% CI -0.84 to 0.92 kg; I² = 0%; 2 studies, 233 participants; low-certainty evidence), may reduce the incidence of bile reflux into the remnant stomach (RR 0.67, 95% CI 0.55 to 0.83; RD -0.29, 95% CI -0.43 to -0.16; number needed to treat for an additional beneficial outcome (NNTB) 4, 95% CI 3 to 7; 1 study, 141 participants; low-certainty evidence), and may have little or no effect on the incidence of remnant gastritis (RR 0.27, 95% CI 0.01 to 5.06; I2 = 78%; RD -0.15, 95% CI -0.23 to -0.07; I2 = 0%; NNTB 7, 95% CI 5 to 15; 2 studies, 265 participants; very low-certainty evidence). No studies reported on quality of life or the incidence of oesophagitis. Uncut Roux-en-Y reconstruction versus Roux-en-Y reconstruction In the realm of surgical complications, very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Roux-en-Y reconstruction may make little to no difference to major postoperative complications (RR 4.74, 95% CI 0.23 to 97.08; I² not applicable; RD 0.01, 95% CI -0.02 to 0.04; I² = 0%; 2 studies, 256 participants; very low-certainty evidence) and incidence of anastomotic leakage (RR 0.34, 95% CI 0.05 to 2.08; I² = 0%; RD -0.02, 95% CI -0.06 to 0.02; I² = 0%; 2 studies, 213 participants; very low-certainty evidence). We are very uncertain about these results. Focusing on long-term outcomes, very low-certainty evidence suggests that uncut Roux-en-Y reconstruction compared with Roux-en-Y reconstruction may increase the incidence of bile reflux into the remnant stomach (RR 10.74, 95% CI 3.52 to 32.76; RD 0.57, 95% CI 0.43 to 0.71; NNT for an additional harmful outcome (NNTH) 2, 95% CI 2 to 3; 1 study, 108 participants; very low-certainty evidence) and may make little to no difference to the incidence of remnant gastritis (RR 1.18, 95% CI 0.69 to 2.01; I² = 60%; RD 0.03, 95% CI -0.03 to 0.08; I² = 0%; 3 studies, 361 participants; very low-certainty evidence) and incidence of oesophagitis (RR 0.82, 95% CI 0.53 to 1.26; I² = 0%; RD -0.02, 95% CI -0.07 to 0.03; I² = 0%; 3 studies, 361 participants; very low-certainty evidence). We are very uncertain about these results. Data were insufficient to assess the impact on quality of life and changes in body weight.

Authors' conclusions: Given the predominance of low- to very low-certainty evidence, this Cochrane review faces challenges in providing definitive clinical guidance. We found the majority of critical outcomes may be comparable between the uncut Roux-en-Y reconstruction and other methods, but we are very uncertain about most of these results. Nevertheless, it indicates that uncut Roux-en-Y reconstruction may reduce the incidence of bile reflux compared to Billroth-II reconstruction, albeit with low certainty. In contrast, compared to Roux-en-Y reconstruction, uncut Roux-en-Y may increase bile reflux incidence, based on very low-certainty evidence. To strengthen the evidence base, further rigorous and long-term trials are needed. Additionally, these studies should explore variations in surgical procedures, particularly regarding uncut devices and methods to prevent recanalisation. Future research may potentially alter the conclusions of this review.

Trial registration: ClinicalTrials.gov NCT02644148 NCT02694081 NCT03624725 NCT02763878 NCT03349398.

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Conflict of interest statement

ZC has no interest to declare.

CL has no interest to declare.

MM has no interest to declare.

QM has no interest to declare.

ZJ has no interest to declare.

BL has no interest to declare.

BZ has no interest to declare.

GJ is the original researcher of the RCT entitled 'Total laparoscopic uncut Roux‐en‐Y for radical distal gastrectomy'. This trial has been registered in the Chinese Clinical Trial Registry: ChiCTR‐INR‐17010594. Since GJ is the original researcher of a study that was included in the review, he did not participate in the application of the overall study inclusion and exclusion criteria, and did not make study eligibility decisions about, extract data from, carry out the risk of bias assessment for, or perform GRADE assessments on that study.

Figures

1
1
Reconstruction methods after distal gastrectomy for gastric cancer. (Figure created by the authors of this review).
2
2
Flow diagram of study selection
1.1
1.1. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 1: Major postoperative complications
1.2
1.2. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 2: Incidence of anastomotic leakage
1.3
1.3. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 3: Minor postoperative complications
1.4
1.4. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 4: Length of hospital stay
1.5
1.5. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 5: Changes in body weight (kg) from baseline
1.6
1.6. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 6: Incidence of bile reflux
1.7
1.7. Analysis
Comparison 1: Uncut Roux‐en‐Y reconstruction versus Billroth II reconstruction, Outcome 7: Incidence of remnant gastritis
2.1
2.1. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 1: Major postoperative complications
2.2
2.2. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 2: Incidence of anastomotic leakage
2.3
2.3. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 3: Minor postoperative complications
2.4
2.4. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 4: Length of hospital stay
2.5
2.5. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 5: Incidence of bile reflux
2.6
2.6. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 6: Incidence of remnant gastritis
2.7
2.7. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 7: Incidence of remnant gastritis (subgroup analysis according to open or minimally invasive surgery)
2.8
2.8. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 8: Incidence of remnant gastritis (Sensitivity analysis according to risk of bias)
2.9
2.9. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 9: Incidence of oesophagitis
2.10
2.10. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 10: Incidence of oesophagitis (subgroup analysis according to open or minimally invasive surgery)
2.11
2.11. Analysis
Comparison 2: Uncut Roux‐en‐Y reconstruction versus Roux‐en‐Y reconstruction, Outcome 11: Incidence of oesophagitis (sensitivity analysis according to risk of bias)
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References

References to studies included in this review

Chen 2018 {unpublished data only}
    1. Chen L. The contrast on effect of nondetached Roux-en-Y and Billroth II plus Braun on prevention of bile reflux postoperative gastric cancer [腹腔镜非离断Roux-en-Y对比毕Ⅱ加Braun术式在胃癌术后预防胆汁返流的效果]. https://d.wanfangdata.com.cn/thesis/ChJUaGVzaXNOZXdTMjAyMzAxMTASCUQwMTQ1... 2018. [DOI: 10.7666/d.D01451069] - DOI
Lin 2019 {unpublished data only}
    1. Lin Y. Long-term complications and quality of life of uncut Roux-en-Y anastomosis and Billroth II anastomosis in laparoscopic D2 radical resection of distal gastric cancer: a randomized controlled trial [Uncut Roux-en-Y吻合与Billroth Ⅱ吻合对远端胃癌腹腔镜D2根治术远期并发症,生活质量影响随机对照研究]. https://d.wanfangdata.com.cn/thesis/ChJUaGVzaXNOZXdTMjAyMzAxMTASCUQwMTg4... 2019.
Luo 2020 {published data only}
    1. Luo H, Wang W, Xie Y, Tan B, Xing Z, Lu T. Effect and safety of uncut Roux-en-Y reconstruction in laparoscopic distal gastric cancer surgery [Uncut Roux-en-Y重建在腹腔镜远端胃癌手术中的效果及安全性]. Chinese Journal of Current Advances in General Surgery [Chinese Medical Journal] 2020;23(10):814-7. [DOI: 10.3969/j.issn.1009-9905.2020.10.014] - DOI
Noh 2000 {published data only}
    1. Noh SM. Improvement of the Roux limb function using a new type of "uncut Roux" limb. American Journal of Surgery 2000;180(1):37-40. [DOI: 10.1016/s0002-9610(00)00421-9] - DOI - PubMed
Wang 2021 {published data only}
    1. ChiCTR-INR-17010594. Laparoscopic uncut Roux-en-Y (URY) compared with laparoscopic Billroth II plus Braun reconstruction of digestive tract in prevention of bile reflux after radical resection of distal gastric cancer: a randomized, single blind, multicenter clinical trial [腹腔镜非离断Roux-en-Y(Uncut Roux-en-Y, URY)对比毕Ⅱ加Braun预防远端进展期胃癌根治术后胆汁返流效果的随机、单盲、多中心临床试验]. https://www.chictr.org.cn/showproj.html?proj=17879 (first received 9 February 2017).
    1. Wang J, Wang Q, Dong J, Yang K, Ji S, Fan Y, et al. Total laparoscopic uncut Roux-en-Y for radical distal gastrectomy: an interim analysis of a randomized, controlled, clinical trial. Annals of Surgical Oncology 2021;28(1):90-6. [DOI: 10.1245/s10434-020-08710-4] - DOI - PubMed
    1. Wang Q, Ni Q, Yang K, Ji S, Fan Y, Wang C, et al. Laparoscopic uncut Roux-en-Y for radical distal gastrectomy: the study protocol for a multirandomized controlled trial. Cancer Management and Research 2019;11:1697-704. [DOI: 10.2147/CMAR.S170355] - DOI - PMC - PubMed
Xie 2023 {published data only}
    1. ChiCTR1800015228. The clinical application and optimization of uncut Roux-en-Y anastomosis in laparoscopic distal radical gastrectomy [腹腔镜远端胃癌根治术Uncut Roux-en-Y吻合的优化与临床应用]. https://www.chictr.org.cn/showproj.html?proj=25862 (first received 16 March 2018).
    1. Xie H, Wu F, Huang C, Chen Q, Ni Z, Wang S, et al. Tranditional Roux-en-Y vs uncut Roux-en-Y in laparoscopic distal gastrectomy: a randomized controlled study. Journal of Gastrointestinal Surgery 2023;27(6):1098–105. [DOI: 10.1007/s11605-023-05644-6] - DOI - PMC - PubMed
Xu 2023 {published data only}
    1. ChiCTR-IOR-15006466. The effect of uncut Roux-en-Y gastrojejunostomy on quality of life after laparoscopic distal gastrectomy for early gastric cancer patients [胃肠uncut Roux-en-Y吻合术提高早期胃癌腹腔镜下远端胃切除术后患者生活质量的临床随机对照研究]. https://www.chictr.org.cn/showproj.html?proj=11076 (first received 30 May 2015).
    1. Uncut Roux-en-Y gastrojejunostomy for early gastric cancer patients. https://clinicaltrials.gov/ct2/show/NCT02644148 (first received 31 December 2015).
    1. Xu H, Xu JK, Li YF, Wang JL, Zhang CD, Yang L, et al. A trial about short-term outcomes of uncut Roux-en-Y reconstruction for early gastric cancer. Clinical Nutrition 2019;38(Suppl 1):S172. [DOI: 10.1016/S0261-5614(19)32935-8] - DOI
    1. Xu H, Yang L, Zhang DC, Li Z, Li QY, Wang LJ, et al. To cut or not to cut? A prospective randomized controlled trial on short-term outcomes of the uncut Roux-en-Y reconstruction for gastric cancer. Surgical Endoscopy 2023;37(8):6172-84. [DOI: 10.1007/s00464-023-10067-0] - DOI - PMC - PubMed
    1. Xu H, Zhang DC, Yang L, Xu ZK. Short-term outcomes of uncut Roux-en-Y reconstruction for early gastric cancer [早期胃癌uncut Roux-en-Y重建术后短期营养观察]. In: The 2019 Chinese Congress on Oncology. 2019:1783.
Yang 2017 {published data only}
    1. The advantages and disadvantages between uncut Roux-en-Y reconstruction and Billroth II reconstruction after laparoscopy-assisted distal gastrectomy for gastric. clinicaltrials.gov/ct2/show/NCT02694081 (first received 29 February 2016).
    1. Yang D, He L, Tong WH, Jia ZF, Su TR, Wang Q. Randomized controlled trial of uncut Roux-en-Y vs Billroth II reconstruction after distal gastrectomy for gastric cancer: which technique is better for avoiding biliary reflux and gastritis? World Journal of Gastroenterology 2017;23(34):6350-6. [DOI: 10.3748/wjg.v23.i34.6350] - DOI - PMC - PubMed
Zhou 2023 {published data only}
    1. ChiCTR-IOR-17013072. The effect of uncut Roux-en-Y alimentary reconstruction and Billroth II alimentary reconstruction on the long-term complications and quality of life after laparoscopic D2 radical gastrectomy for distal gastric cancer: a single center, open, superiority of randomized controlled clinical trial [Uncut Roux-en-Y吻合与Billroth II 吻合对远端胃癌患者腹腔镜D2根治术后远期并发症，生活质量影响的单中心、开放性、优效性随机对照研究]. https://www.chictr.org.cn/showproj.html?proj=21565 (first received 21 October 2017).
    1. Zhou C, Ou W, Sun L, Chen R, Wu J, Xu F, et al. Effects of uncut roux-en-Y vs. of Billroth Ⅱ anastomosis on complications and quality of life of patients with distal gastric cancer after laparoscopic D2 radical surgery: a randomized controlled study [未离断Roux-en-Y对比毕Ⅱ吻合对远端胃癌患者腹腔镜D2根治术后并发症和生活质量的影响]. Chinese Journal of Experimental Surgery 2023;40(03):532-6. [DOI: 10.3760/cma.j.cn421213-20220810-01245] - DOI
Zuo 2019 {published data only}
    1. Zuo H. Effect of non-disconnected Roux-en-Y anastomosis on intestinal flora and functional recovery in elderly patients with distal gastric cancer after operation [非离断式Roux-en-Y吻合对老年远端胃癌术后康复的影响]. Chinese Journal of Geriatric Care [Chinese Medical Journal] 2019;17(4):70-2. [DOI: 10.3969/j.issn.1672-2671.2019.04.022] - DOI

References to studies excluded from this review

Cai 2020 {published data only}
    1. Cai W. Efficacy and safety of uncut Roux-en-Y anastomoses used in patients undergoing gastrointestinal reconstruction after total laparoscopic distal gastrectomy [非离断鲁氏Y形吻合术用于全腹腔镜远端胃癌根治术后消化道重建术患者中的效果及安全性]. Chinese Journal of Medical Device 2020;33(23):73-4. [DOI: 10.3969/j.issn.1002-2376.2020.23.038] - DOI
Ren 2020 {published data only}
    1. Ren N, Liu X, Wei L, Cui J. Comparison of Billroth Ⅱ combining Braun anastomosis and Roux-en-Y anastomosis in laparoscopic distal gastric cancer surgery [全腹腔镜远端胃癌根治术中2种吻合方式临床疗效的对比]. Chinese Journal of Current Advances in General Surgery 2020;23(3):197-9, 206. [DOI: 10.3969/j.issn.1009-9905.2020.03.008] - DOI
Wei 2018 {published data only}
    1. Wei Y, Tang Z, Liu X. Impact of totally laparoscopic uncut Roux-en-Y anastomosis for radical resection of distal gastric cancer on short-term outcomes [远端胃癌根治术采用全腹腔镜非离断式Roux-en-Y吻合对近期疗效的影响分析]. China Medical Device Information 2018;24(22):58-9. [DOI: 10.3969/j.issn.1006-6586.2018.22.030] - DOI

References to studies awaiting assessment

Cai 2023 {published data only}
    1. Cai H. Evaluation of the effect of Roux-en-Y anastomosis in gastric cancer digestive tract reconstruction surgery [在胃癌消化道重建手术中应用非离断式Roux-en-Y吻合术的效果评价]. Contemporary Medicine Forum[当代医药论丛] 2023;21(7):44-6. [NUMBER IN JOURNAL: 2095-7629-（2023）07-0044-03]
ChiCTR2000037056 {unpublished data only}
    1. Comparison of the efficacy and prognosis of different digestive tract reconstruction methods in laparoscopic radical gastrectomy for distal gastric cancer [不同消化道重建方式在腹腔镜下远端胃癌根治术中的疗效和预后比较]. https://www.chictr.org.cn/showproj.html?proj=60189 (first received 26 August 2019). [CENTRAL: CN-02436988]
NCT03624725 {unpublished data only}
    1. A clinical study of the effects of modified BII+Braun on quality of life after for distal gastric cancer. https://clinicaltrials.gov/ct2/show/NCT03624725 (first received 10 August 2018).
Shen 2019 {published data only}
    1. Shen H, Hong CY, Deng YW, Liang JZ. Application of uncut Roux-en-Y anastomosis in gastrointestinal reconstruction of total laparoscopic distal gastric cancer radical resection [Uncut Roux-en-Y吻合在全腹腔镜远端胃癌根治术消化道重建中的应用]. Chinese Journal of Gerontology 2019;39(5):1096-9. [DOI: 10.3969/j.issn.1005-9202.2019.05.024] - DOI
Xu 2010 {published data only}
    1. Xu J, Ye Z, Wang Y, Shao Q, Sun Y, Zhao Z. Application of uncut Roux-en-Y anastomosis in radical distal gastrectomy for gastric carcinoma [非离断式Roux-en-Y吻合术在胃窦癌根治性远端胃大部分切除术中的应用]. Zhejiang Medical Journal [Chinese Medical Journal] 2010;32(9):1325-6, 1332. [DOI: 10.3969/j.issn.1006-2785.2010.09.013] - DOI
Zou 2021 {published data only}
    1. Zou J, Yan K, Wu Kun, Rao H, Lin C. Intracavitary uncut Roux-en-Y anastomosis in gastrointestinal tract re-construction of patients undergoing totally laparoscopic distal gastrectomy [腔内非离断式Roux-en-Y吻合术在全腹腔镜远端胃癌根治术消化道重建中的应用]. China Modern Doctor 2021;59(36):64-7.

References to ongoing studies

ChiCTR1900024826 {unpublished data only}
    1. Effect of different digestive tract reconstruction methods on postoperative digestive function in patients undergoing radical distal gastrectomy: a randomized, controlled, multicenter clinical study [远端胃癌根治术中不同消化道重建方式对患者术后消化功能影响的随机、对照、多中心临床研究]. https://www.chictr.org.cn/showproj.html?proj=41615 (first received 7 July 2019).
ChiCTR‐INR‐15007612 {unpublished data only}
    1. Uncut Roux-en-Y versus Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a clinical randomized controlled trial [远端胃癌根治切除术后Uncut Roux-en-Y吻合与Roux-en-Y吻合随机对照试验研究]. https://www.chictr.org.cn/showproj.aspx?proj=12141 (first received 20 December 2015).
ChiCTR‐INR‐17010980 {unpublished data only}
    1. Uncut Roux-en-Y versus Billroth II anastomosis after distal gastrectomy for gastric cancer: a clinical randomized controlled trial [远端胃癌根治切除术后Uncut Roux-en-Y吻合与Billroth II吻合随机对照试验研究]. https://www.chictr.org.cn/showproj.html?proj=18676 (first received 25 March 2017).
NCT02763878 {unpublished data only}
    1. Chen S, Chen DW, Chen XJ, Lin YJ, Xiang J, Peng JS. Postoperative complications and nutritional status between uncut Roux-en-Y anastomosis and Billroth II anastomosis after D2 distal gastrectomy: a study protocol for a multicenter randomized controlled trial. Trials 2019;20(1):428. [DOI: 10.1186/s13063-019-3531-0] [PMID: ] - DOI - PMC - PubMed
    1. Uncut Roux-en-Y anastomosis reduce postoperative complication and improve nutritional status after distal gastrectomy. https://clinicaltrials.gov/ct2/show/NCT02763878 (first received 5 May 2016).
NCT03349398 {unpublished data only}
    1. Uncut Roux-en-Y vs Roux-en-Y. https://clinicaltrials.gov/ct2/show/NCT03349398 (first received 21 November 2017).

Additional references

Ahn 2014
    1. Ahn SH, Son SY, Lee CM, Jung DH, Park do J, Kim HH. Intracorporeal uncut Roux-en-Y gastrojejunostomy reconstruction in pure single-incision laparoscopic distal gastrectomy for early gastric cancer: unaided stapling closure. Journal of the American College of Surgeons 2014;218(1):e17-e21. [DOI: 10.1016/j.jamcollsurg.2013.09.009] - DOI - PubMed
Alkhaffaf 2018
    1. Alkhaffaf B, Blazeby JM, Williamson PR, Bruce IA, Glenny AM. Reporting of outcomes in gastric cancer surgery trials: a systematic review. BMJ Open 2018;8(10):e021796. [DOI: 10.1136/bmjopen-2018-021796] - DOI - PMC - PubMed
Alkhaffaf 2020
    1. Alkhaffaf B, Blazeby JM, Bruce IA, Morris RL. Patient priorities in relation to surgery for gastric cancer: qualitative interviews with gastric cancer surgery patients to inform the development of a core outcome set. BMJ Open 2020;10(2):e034782. [DOI: 10.1136/bmjopen-2019-034782] - DOI - PMC - PubMed
Alkhaffaf 2021
    1. Alkhaffaf B, Metryka A, Blazeby JM, Glenny AM, Adeyeye A, Costa PM, et al. Core outcome set for surgical trials in gastric cancer (GASTROS study): international patient and healthcare professional consensus. British Journal of Surgery 2021;108(10):1216–24. [DOI: 10.1093/bjs/znab192] - DOI - PMC - PubMed
Amin 2017
    1. Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, et al. AJCC Cancer Staging Manual. 8th edition. New York: Springer International Publishing, 2017.
CACA 2022
    1. Gastric Cancer Professional Committee, Chinese Anti-Cancer Association (CACA), Gastrointestinal Surgery Group, Branch of Surgery, Chinese Medical Association, Committee of Upper Gastrointestinal Surgeons, Branch of Surgery, Chinese Medical Doctor Association, Digestive Tumor Committee, Chinese Research Hospital Association. Chinese expert consensus on prevention and treatment of complications related to digestive tract reconstruction after laparoscopic radical gastrectomy for gastric cancer (2022 edition) [腹腔镜胃癌根治术消化道重建相关并发症防治中国专家共识（2022版）]. Chinese Journal of Gastrointestinal Surgery 2022;25(8):659-68. [DOI: 10.3760/cma.j.cn441530-20220712-00302] - DOI
Cai 2018a
    1. Cai Z, Yin Y, Yin Y, Shen C, Wang J, Yin X, et al. Comparative effectiveness of adjuvant treatments for resected gastric cancer: a network meta-analysis. Gastric Cancer 2018;21(6):1031-40. [DOI: 10.1007/s10120-018-0831-0] - DOI - PubMed
Cai 2018b
    1. Cai Z, Zhou Y, Wang C, Yin Y, Yin Y, Shen C, et al. Optimal reconstruction methods after distal gastrectomy for gastric cancer: a systematic review and network meta-analysis. Medicine 2018;97(20):e10823. [DOI: 10.1097/MD.0000000000010823] - DOI - PMC - PubMed
Cai 2018c
    1. Cai Z, Yin Y, Shen C, Wang J, Yin X, Chen Z, et al. Comparative effectiveness of preoperative, postoperative and perioperative treatments for resectable gastric cancer: a network meta-analysis of the literature from the past 20 years. Surgical Oncology 2018;27(3):563-74. [DOI: 10.1016/j.suronc.2018.07.011] - DOI - PubMed
Cai 2022b
    1. Cai Z, Mu M, Zhao Z, Zhang B. A commentary on "Uncut Roux-en-Y might reduce the rate of reflux gastritis after radical distal gastrectomy: an evidence mapping from a systematic review" (Int J Surg 2022;97:106184). International Journal of Surgery 2022;104:106773. [DOI: 10.1016/j.ijsu.2022.106773] - DOI - PubMed
Cai 2024
    1. Cai Z, Zhao Z, Ma Q, Shen C, Jiang Z, Liu C, et al. Midline and off-midline wound closure methods after surgical treatment for pilonidal sinus. Cochrane Database of Systematic Reviews 2024, Issue 1. Art. No: CD015213. [DOI: 10.1002/14651858.CD015213.pub2] - DOI - PMC - PubMed
Campbell 2020
    1. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ 2020;368:16890. [DOI: 10.1136/bmj.l6890] - DOI - PMC - PubMed
Chung 2022
    1. Chung JH, Im DW, Choi CW, Kim SJ, Hwang SH, Lee SH. A 3-year follow-up study of uncut Roux-en-Y reconstruction: clinical results and outcomes. Surgical Endoscopy 2022;36(10):7588-96. [DOI: 10.1007/s00464-022-09198-7] - DOI - PubMed
Clavien 2004
    1. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery 2004;240(2):205-13. [DOI: 10.1097/01.sla.0000133083.54934.ae] - DOI - PMC - PubMed
CSLES 2023
    1. Chinese Society of Laparoscopic and Endoscopic Surgery. Guideline for laparoscopic gastrectomy for gastric cancer (2023 edition) [腹腔镜胃癌手术操作指南 (2023版)]. Chinese Journal of Digestive Surgery 2023;22(4):425-36. [DOI: 10.3760/cma.j.cn115610-20230317-00113] - DOI
Egger 1997
    1. Egger M, Davey SG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34. [DOI: 10.1136/bmj.315.7109.629] - DOI - PMC - PubMed
Eldridge 2021
    1. Eldridge S, Campbell M, Campbell M, Drahota-Towns A, Giraudeau B, Reeves B, et al. Revised Cochrane risk of bias tool for randomized trials (RoB 2). Additional considerations for cluster-randomized trials (RoB 2 CRT); March 2021. Available at sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/rob-2-for-clus....
EndNote 2013 [Computer program]
    1. EndNote. Version X9. PA, USA: Clarivate Analytics, 2013. Available at download.endnote.com/downloads/X9/ENX9Inst.exe.
Glanville 2019
    1. Glanville J, Foxlee R, Wisniewski S, Noel-Storr A, Edwards M, Dooley G. Translating the Cochrane EMBASE RCT filter from the Ovid interface to Embase.com: a case study. Health Information and Libraries Journal 2019;36(3):264-77. [DOI: 10.1111/hir.12269] - DOI - PubMed
GRADEpro GDT 2021 [Computer program]
    1. GRADEpro GDT. Version accessed prior to 20 June 2022. Hamilton (ON): McMaster University (developed by Evidence Prime), 2021. Available at gradepro.org.
Higgins 2019
    1. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions. 2nd edition. Chichester (UK): John Wiley & Sons, 2019. [DOI: 10.1002/9781119536604] - DOI
Hopewell 2007
    1. Hopewell S, McDonald S, Clarke MJ, Egger M. Grey literature in meta‐analyses of randomized trials of health care interventions. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No: MR000010. [DOI: 10.1002/14651858.MR000010.pub3] - DOI - PMC - PubMed
Huang 2016a
    1. Huang Y, Wang S, Shi Y, Tang D, Wang W, Chong Y, et al. Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer. Expert Review of Gastroenterology & Hepatology 2016;10(12):1341-7. [DOI: 10.1080/17474124.2016.1248404] - DOI - PubMed
Huang 2016b
    1. Huang Y, Wang S, Tang D, Jiang X, Wang J, Wang D. Application of uncut Roux-en-Y anastomosis in laparoscopic distal radical gastrectomy of gastric cancer [非离断式Roux-en-Y吻合在腹腔镜远端胃癌根治性切除术中的应用]. Chinese Journal of Digestive Surgery 2016;15(3):247-52. [DOI: 10.3760/cma.j.issn.1673-9752.2016.03.008] - DOI
Iwakiri 2022
    1. Iwakiri K, Fujiwara Y, Manabe N, Ihara E, Kuribayashi S, Akiyama J, et al. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021. Journal of Gastroenterology 2022;57(4):267-85. [DOI: 10.1007/s00535-022-01861-z] - DOI - PMC - PubMed
Jangjoo 2010
    1. Jangjoo A, Mehrabi Bahar M, Aliakbarian M. Uncut Roux-en-Y esophagojejunostomy: a new reconstruction technique after total gastrectomy. Indian Journal of Surgery 2010;72(3):236-9. [DOI: 10.1007/s12262-010-0059-7] - DOI - PMC - PubMed
JGCA 2023
    1. Japanese Gastric Cancer Association. Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). Gastric Cancer 2023;26(1):1-25. [DOI: 10.1007/s10120-022-01331-8] - DOI - PMC - PubMed
Jiao 2022
    1. Jiao YJ, Lu TT, Liu DM, Xiang X, Wang LL, Ma SX, et al. Comparison between laparoscopic uncut Roux-en-Y and Billroth II with Braun anastomosis after distal gastrectomy: a meta-analysis. World journal of gastrointestinal surgery 2022;14(6):594-610. [DOI: 10.4240/wjgs.v14.i6.594] - DOI - PMC - PubMed
Kinoshita 2020
    1. Kinoshita T, Honda M, Matsuki A, Enomoto N, Aizawa M, Nunobe S, et al. Billroth-I vs Roux-en-Y after distal gastrectomy: a comparison of long-term nutritional status and survival rates from a large-scale multicenter cohort study. Annals of Gastroenterological Surgery 2020;4(2):142-50. [DOI: 10.1002/ags3.12309] - DOI - PMC - PubMed
Kleba 1998
    1. Kleba T. Gastroscopic criteria and most frequent pain in bile reflux gastritis [Kryteria gastroskopowe oraz najczestsze dolegliwości w zółciowym zapaleniu błony śluzowej zoładka]. Polski Merkuriusz Lekarski 1998;4(22):190-2. [PMID: ] - PubMed
Kubo 2002
    1. Kubo M, Sasako M, Gotoda T, Ono H, Fujishiro M, Saito D, et al. Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification. Gastric Cancer 2002;5(2):83-9. [DOI: 10.1007/s101200200014] - DOI - PubMed
Li 2018
    1. Li Z, Wu Q, Ji J. Expert Consensus on the Diagnostic Registration Criteria for Postoperative complications of Gastrointestinal Cancer surgery in China (2018 edition) [中国胃肠肿瘤外科术后并发症诊断登记规范专家共识(2018版)]. Chinese Journal of Practical Surgery 2018;38(6):589-95. [DOI: 10.19538/j.cjps.issn1005-2208.2018.06.01] - DOI
Li 2022a
    1. Li Y, Wang Q, Yang KL, Wang J, Jiang KW, Ye YJ. Uncut Roux-en-Y might reduce the rate of reflux gastritis after radical distal gastrectomy: an evidence mapping from a systematic review. International Journal of Surgery 2022;97:106184. [DOI: 10.1016/j.ijsu.2021.106184] - DOI - PubMed
Li 2022b
    1. Li XG, Song QY, Wu D, Li S, Zhang BL, Zhang LY, et al. Does the addition of Braun anastomosis to Billroth II reconstruction on laparoscopic-assisted distal gastrectomy benefit patients? World Journal of Gastrointestinal Oncology 2022;14(6):1141-7. - PMC - PubMed
Lombardo 2022
    1. Lombardo F, Aiolfi A, Cavalli M, Mini E, Lastraioli C, Panizzo V, et al. Techniques for reconstruction after distal gastrectomy for cancer: updated network meta-analysis of randomized controlled trials. Langenbeck's Archives of Surgery 2022;407(1):75-86. [DOI: 10.1007/s00423-021-02411-6] - DOI - PubMed
Lundell 1999
    1. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45(2):172. [DOI: 10.1136/gut.45.2.172] - DOI - PMC - PubMed
Luo 2019
    1. Luo J. Meta-analysis of comparison between uncut Roux-en-Y and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer [远端胃癌根治术后Uncut Roux-en-Y型和Billroth Ⅱ型消化道重建方式对比的荟萃分析]. https://kns.cnki.net/kcms2/article/abstract?v=ohXIcpZjJKxwYyyIPbtbJRsdkf... 2019.
Ma 2019
    1. Ma Y, Li F, Zhou X, Wang B, Lu S, Wang W, et al. Four reconstruction methods after laparoscopic distal gastrectomy: a systematic review and network meta-analysis. Medicine (Baltimore) 2019;98(51):e18381. [DOI: 10.1097/md.0000000000018381] - DOI - PMC - PubMed
Mark 2019 [Computer program]
    1. Engauge Digitizer Software. Mark M, Baurzhan M, Tobias W, Bas S, Alexander W, Sower K, et al, Version 12.1. Mark Mitchell, 2019. Available at markummitchell.github.io/engauge-digitizer.
Marshall 1999
    1. Marshall RE, Anggiansah A, Owen WA, Owen WJ. Investigation of oesophageal reflux symptoms after gastric surgery with combined pH and bilirubin monitoring. British Journal of Surgery 1999;86(2):271-5. [DOI: 10.1046/j.1365-2168.1999.00951.x] - DOI - PubMed
McCall 2016
    1. McCall MD, Graham PJ, Bathe OF. Quality of life: a critical outcome for all surgical treatments of gastric cancer. World Journal of Gastroenterology 2016;22(3):1101. [DOI: 10.3748/wjg.v22.i3.1101] - DOI - PMC - PubMed
McNally 2010
    1. McNally PR. GI/Liver Secrets Plus. 4th edition. Elsevier Health Sciences, 2010. [DOI: 10.1016/B978-0-323-06397-5.X0001-9] - DOI
Miedema 1992
    1. Miedema BW, Kelly KA. The Roux stasis syndrome: treatment by pacing and prevention by use of an 'uncut' Roux limb. Archives of Surgery 1992;127(3):295-300. [DOI: 10.1001/archsurg.1992.01420030057011] - DOI - PubMed
Min 2022
    1. Min JS, Kim RB, Seo KW, Jeong SH. Comparison of the clinical outcomes of reconstruction methods after distal gastrectomy: a systematic review and meta-analysis based on randomized controlled trials. Journal of Gastric Cancer 2022;22(2):83-93. [DOI: 10.5230/jgc.2022.22.e9] - DOI - PMC - PubMed
Morrison 1990
    1. Morrison P, Miedema BW, Kohler L, Kelly KA. Electrical dysrhythmias in the Roux jejunal limb: cause and treatment. American Journal of Surgery 1990;160(3):252-6. [DOI: 10.1016/S0002-9610(06)80017-6] - DOI - PubMed
Nishizaki 2021
    1. Nishizaki D, Ganeko R, Hoshino N, Hida K, Obama K, Furukawa TA, et al. Roux-en-Y versus Billroth-I reconstruction after distal gastrectomy for gastric cancer. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No: CD012998. [DOI: 10.1002/14651858.CD012998.pub2] - DOI - PMC - PubMed
Noh 2000
    1. Noh SM. Improvement of the Roux limb function using a new type of "uncut Roux" limb. American Journal of Surgery 2000;180(1):37-40. [DOI: 10.1016/s0002-9610(00)00421-9] - DOI - PubMed
Page 2021
    1. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021;372:n160. [DOI: 10.1136/bmj.n160] - DOI - PMC - PubMed
Park 2014
    1. Park JY, Kim YJ. Uncut Roux-en-Y reconstruction after laparoscopic distal gastrectomy can be a favorable method in terms of gastritis, bile reflux, and gastric residue. Journal of Gastric Cancer 2014;14(4):229-37. [DOI: 10.5230/jgc.2014.14.4.229] - DOI - PMC - PubMed
Park 2018
    1. Park YS, Shin DJ, Son SY, Kim KH, Park DJ, Ahn SH, et al. Roux stasis syndrome and gastric food stasis after laparoscopic distal gastrectomy with uncut Roux-en-Y reconstruction in gastric cancer patients: a propensity score matching analysis. World Journal of Surgery 2018;42(12):4022-32. [DOI: 10.1007/s00268-018-4715-6] - DOI - PubMed
RevMan Web 2024 [Computer program]
    1. Review Manager Web (RevMan Web). Version 7.4.0. The Cochrane Collaboration, 2024. Available at revman.cochrane.org.
Sah 2020
    1. Sah BK, Li J, Yan C, Li C, Yan M, Zhu ZG. Anastomosis for distal gastrectomy in Chinese patients: uncut Roux-Y or Roux-Y?. BMC Surgery 2020;20(1):7. [DOI: 10.1186/s12893-019-0672-8] - DOI - PMC - PubMed
Salandra 2022
    1. Salandra R, Criscuolo P, Salter A. The power of weak signals: how systematic reviews direct researchers away from potentially biased primary studies. Cochrane Database of Systematic Reviews 2022;(11):ED000160. [DOI: 10.1002/14651858.ED000160] - DOI - PMC - PubMed
Santesso 2020
    1. Santesso N, Glenton C, Dahm P, Garner P, Akl EA, Alper B, et al. GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. Journal of Clinical Epidemiology 2020;119:126-35. [DOI: 10.1016/j.jclinepi.2019.10.014] - DOI - PubMed
Scarpellini 2020
    1. Scarpellini E, Arts J, Karamanolis G, Laurenius A, Siquini W, Suzuki H, et al. International consensus on the diagnosis and management of dumping syndrome. Nature Reviews. Endocrinology 2020;16(8):448-66. [DOI: 10.1038/s41574-020-0357-5] - DOI - PMC - PubMed
Schulz 2010
    1. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332. [DOI: 10.1136/bmj.c332] - DOI - PMC - PubMed
So 2018
    1. So JB, Rao J, Wong AS, Chan YH, Pang NQ, Tay AYL, et al. Roux-en-Y or Billroth II reconstruction after radical distal gastrectomy for gastric cancer. Annals of Surgery 2018;267(2):236-42. [DOI: 10.1097/SLA.0000000000002229] - DOI - PubMed
Sterne 2019
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. [DOI: 10.1136/bmj.l4898] - DOI - PubMed
Sun 2018
    1. Sun MM, Fan YY, Dang SC. Comparison between uncut Roux-en-Y and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: a meta-analysis. World Journal of Gastroenterology 2018;24(24):2628-39. [DOI: 10.3748/wjg.v24.i24.2628] - DOI - PMC - PubMed
Sung 2021
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a Cancer Journal for Clinicians 2021;71(3):209-49. [DOI: 10.3322/caac.21660] - DOI - PubMed
Tu 1995
    1. Tu BN, Kelly KA. Elimination of the Roux stasis syndrome using a new type of “uncut Roux” limb. American Journal of Surgery 1995;170(4):381-6. [DOI: 10.1016/S0002-9610(99)80308-0] - DOI - PubMed
Uyama 2005
    1. Uyama I, Sakurai Y, Komori Y, Nakamura Y, Syoji M, Tonomura S, et al. Laparoscopy-assisted uncut Roux-en-Y operation after distal gastrectomy for gastric cancer. Gastric Cancer 2005;8(4):253-7. [DOI: 10.1007/s10120-005-0344-5] - DOI - PubMed
Van Stiegmann 1988
    1. Van Stiegmann G, Goff JS. An alternative to Roux-en-Y for treatment of bile reflux gastritis. Surgery, Gynecology & Obstetrics 1988;166(1):69-70. [PMID: ] - PubMed
Wang 2021a
    1. Wang FH, Zhang XT, Li YF, Tang L, Qu XJ, Ying JE, et al. The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021. Cancer Communications 2021;41(8):747-95. [DOI: 10.1002/cac2.12193] - DOI - PMC - PubMed
Wang 2021b
    1. Wang J, Wang Q, Dong J, Yang K, Ji S, Fan Y, et al. Total laparoscopic uncut Roux-en-Y for radical distal gastrectomy: an interim analysis of a randomized, controlled, clinical trial. Annals of Surgical Oncology 2021;28(1):90-6. [DOI: 10.1245/s10434-020-08710-4] - DOI - PubMed
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta‐epidemiological study. BMJ 2008;336(7644):601‐5. [DOI: 10.1136/bmj.39465.451748.AD] - DOI - PMC - PubMed
Wu 2021
    1. Wu F, Ni Z, Diao H, Huang C, Wang S, Ge B, et al. Recanalization in uncut Roux-en-Y reconstruction: an animal experiment and a clinical study. Frontiers in Surgery 2021;8:644864. [DOI: 10.3389/fsurg.2021.644864] - DOI - PMC - PubMed
Xia 2022
    1. Xia C, Dong X, Li H, Cao M, Sun D, He S, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chinese Medical Journal 2022;135(5):584-90. [DOI: 10.1097/CM9.0000000000002108] - DOI - PMC - PubMed
Xiao 2021
    1. Xiao YL, Zhou LY, Hou XH, Li YQ, Zou DW, Chen MH, et al. Chinese expert consensus on gastroesophageal reflux disease in 2020. Journal of Digestive Diseases 2021;22(7):376-89. [DOI: 10.1111/1751-2980.13028] - DOI - PubMed
Xue 2015
    1. Xue K, Li ZY, Shan F, Wang YK, Ji JF. V-Loc based uncut Roux-en-Y reconstruction in totally laparoscopic distal gastrectomy: a report of 7 patients [全腹腔镜远端胃癌根治术中基于V-Loc缝线改良非离断式Roux-en-Y重建7例报告]. Chinese Journal of Practical Surgery 2015;35(10):1095-8. [DOI: 10.7504/CJPS.ISSN1005-2208.2015.10.18] - DOI
Yan 2022
    1. Yan Y, Wang D, Liu Y, Lu L, Wang X, Zhao Z, et al. Optimal reconstruction after laparoscopic distal gastrectomy: a single-center retrospective study. Cancer Control 2022;29:10732748221087059. [DOI: 10.1177/10732748221087059] - DOI - PMC - PubMed
Ye 2022
    1. Ye XS, Lin X, Liu JJ, Shi Y, Qian F, Yu PW, et al. Comparison of clinical efficacy and quality of life between uncut Roux-en-Y and Billroth II with Braun anastomosis in laparoscopic distal gastrectomy for gastric cancer [腹腔镜远端胃癌根治术非离断Roux-en-Y吻合与毕Ⅱ+Braun吻合的临床疗效及生活质量的比较]. Zhonghua Wei Chang Wai Ke za Zhi [Chinese Journal of Gastrointestinal Surgery] 2022;25(2):166-72. [DOI: 10.3760/cma.j.cn441530-20210702-00257] - DOI - PubMed
Zhu 2020
    1. Zhu GX, Qu JJ, Zhou SJ. Prevention of closure point recanalization after uncut Roux-en-Y anastomosis for radical resection of distal gastric cancer [远端胃癌根治性切除非离断Roux-en-Y吻合术后闭合点再通的预防]. Zhonghua Wei Chang Wai Ke za Zhi [Chinese Journal of Gastrointestinal Surgery] 2020;23(7):717-9. [DOI: 10.3760/cma.j.cn.441530-20190716-00277] - DOI - PubMed

References to other published versions of this review

Cai 2022
    1. Cai Z, Liu C, Ji G, Chen J, Mu M, Jiang Z, et al. Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer. Cochrane Database of Systematic Reviews 2022, Issue 6. Art. No: CD015014. [DOI: 10.1002/14651858.CD015014] - DOI - PMC - PubMed

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