A CARE-compliant article: a case of retrograde intussusception with Uncut-Roux-en-Y anastomosis after radical total gastrectomy: Review of the literature

Intussusception after reconstruction following gastrectomy for gastric cancer

Background

Gastric cancer is the most prevalent tumor in Chinese men, and surgery is currently the most important treatment. Billroth II and Roux-en-Y are the anastomosis methods used for reconstruction after gastrectomy. Jejunal intussusception is a rare complication after gastric surgery.

Main Body

Intussusception after gastric surgery occurs mostly at the gastrojejunostomy site for Billroth II reconstruction, and the Y-anastomosis site for Roux-en-Y reconstruction. Many studies have reported that postoperative intussusception appears at the anastomosis after bariatric surgery, while a few have reported intussusception at the anastomosis and its distal end after radical gastrectomy.

Conclusion

A review was carried out to analyze intussusception after radical gastrectomy with roux-en-y anastomosis during the current situation. And the relevant mechanisms, diagnosis, treatment methods, etc. are described, hoping to provide better guidance for clinicians

The effects of uncut Roux-en-Y anastomosis on laparoscopic radical gastrectomy patients' postoperative complications and quality of life

OBJECTIVES

This study discusses and analyzes the effects of uncut Roux-en-Y anastomosis on the postoperative complications and quality of life of gastric cancer patients after they undergo laparoscopic total gastrectomies.

METHODS

86 patients admitted to our hospital for laparoscopic digestive tract reconstruction after distal gastrectomies were recruited as the study cohort and divided into group A (n=41) or group B (n=45) on the basis of the different digestive tract reconstruction surgery each patient underwent. The group-A patients underwent traditional Roux-en-Y anastomosis, and the group-B patients underwent uncut Roux-en-Y anastomosis. The operation outcomes, the early and late postoperative complications, the decline in the postoperative nutrition status, and the changes in the postoperative quality of life scores were compared between the two groups.

RESULTS

The intraoperative anastomosis times and the blood losses, the postoperative ventilation, the liquid food intake times, and the hospitalization durations in group B were lower than they were in group A (P<0.05). The incidences of early and late postoperative complications in group A was significantly higher than they were in group B (P<0.05). The decrease of the TP, ALB, and Hb levels in group B was dramatically lower than it was in group A at 6 months after the surgeries (P<0.05), and no significant difference in the TP, ALB, or Hb levels was observed between the two groups at 12 months after the surgeries (P>0.05). The QOL scores in the two groups of patients were increased at 6 and 12 months after the surgeries compared with 1 month after the surgeries (P<0.05). The QOL scores in group B were notably higher than they were in group A at 6 and 12 months after the surgeries (P<0.05).

CONCLUSION

Uncut Roux-en-Y anastomosis after laparoscopic total gastrectomy is simple to carry out. The method can promote patients' early postoperative recovery, reduce their early and late complications, and maintain their postoperative nutritional status, thus improving their postoperative quality of life, so it is worthy of clinical promotion.