Original Article
Clinical research of totally laparoscopic modified Roux-en-Y reconstruction
Abstract
Background: To evaluate the clinical efficacy of improved Roux-en-Y reconstruction after Totally laparoscopic total gastrectomy (LTG) for gastric cancer.
Methods: Clinical data of 36 patients who underwent totally laparoscopic total gastrectomy with intracorporeal Roux-en-Y reconstruction for gastric cancer with complete follow-up data between January 2014 and December 2014 in the Second Hospital of Jilin University. Patients were divided into modified Roux-en-Y group (MRY 20 cases), classic Roux-en-Y group (CRY 16 cases) according to reconstructive methods.
Results: All cases were successfully completed, without conversion to laparotomy. There were no significant differences in lymph nodes harvest, time to flatus, hospital stay and postoperative complications between the two groups. However, the MRY group had shorter mean operative time [(260.9±21.2) vs. (287.9±19.0) min, P=0.000], shorter mean reconstruction duration [(32.4±9.2) vs. (45.4±13.2) min, P=0.001] and less intraoperative bleeding [(50.9±23.5 vs. (67.0±20.5) mL, P=0.000]. The dissection of the mesentery of the jejunum and the jejunum resection were not needed in the MRY group.
Conclusions: The Modified Roux-en-Y reconstruction (MRY) is feasible and safe. It can short the mean operative time, simplify the surgical procedures.
Methods: Clinical data of 36 patients who underwent totally laparoscopic total gastrectomy with intracorporeal Roux-en-Y reconstruction for gastric cancer with complete follow-up data between January 2014 and December 2014 in the Second Hospital of Jilin University. Patients were divided into modified Roux-en-Y group (MRY 20 cases), classic Roux-en-Y group (CRY 16 cases) according to reconstructive methods.
Results: All cases were successfully completed, without conversion to laparotomy. There were no significant differences in lymph nodes harvest, time to flatus, hospital stay and postoperative complications between the two groups. However, the MRY group had shorter mean operative time [(260.9±21.2) vs. (287.9±19.0) min, P=0.000], shorter mean reconstruction duration [(32.4±9.2) vs. (45.4±13.2) min, P=0.001] and less intraoperative bleeding [(50.9±23.5 vs. (67.0±20.5) mL, P=0.000]. The dissection of the mesentery of the jejunum and the jejunum resection were not needed in the MRY group.
Conclusions: The Modified Roux-en-Y reconstruction (MRY) is feasible and safe. It can short the mean operative time, simplify the surgical procedures.
