The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis
Summary: Background: In this study, we propose an improved Roux-en-Y (RY) surgical method by constructing a proximal jejunum pouch (PP-RY). Postoperative results were evaluated among patients with gastric cancer who underwent PP-RY and standard RY anastomosis. Methods: The clinical data of patients...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958421003742 |
| _version_ | 1818366009840500736 |
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| author | Jiaju Lu Zehui Wu Gang Liu Bing Wang Lianghui Shi |
| author_facet | Jiaju Lu Zehui Wu Gang Liu Bing Wang Lianghui Shi |
| author_sort | Jiaju Lu |
| collection | DOAJ |
| description | Summary: Background: In this study, we propose an improved Roux-en-Y (RY) surgical method by constructing a proximal jejunum pouch (PP-RY). Postoperative results were evaluated among patients with gastric cancer who underwent PP-RY and standard RY anastomosis. Methods: The clinical data of patients with gastric cancer who underwent laparoscopic total gastrectomy (LTG) in our center from May 2019 to May 2020 were collected retrospectively. We compared the short-term results of patients in the PP-RY and RY groups using 1:1 propensity score matching (PSM). Results: A total of 317 patients were selected, including those who received RY (n = 249) or PP-RY (n = 68) after LTG. After PSM, both groups had a sample size of 68. During the one-year follow-up period, the incidences of postoperative dumping syndrome (5.6%) and reflux esophagitis (14.8%) were significantly lower in the PP-RY group (P = 0.001 and P = 0.010, respectively). Weight loss (6.5 ± 2.0 kg) and albumin decrease (0.2 ± 0.1 g/dl) were significantly lower (P = 0.038 and P < 0.001, respectively), and the prognostic nutritional index (PNI) was significantly higher in the PP-RY group (P = 0.009). In the QLQ-C30 scale, the degree of anorexia in the PP-RY group was significantly lower than that in the RY group (P＜0.05). In the QLQ-STO22 scale, chest and abdomen pain, dietary restriction, and anxiety were significantly lower in the PP-RY group (all P＜0.05). Conclusion: PP-RY can lead to obvious improvements in nutritional status, reduce short-term complications, and improve quality of life (QoL) for patients after LTG. |
| first_indexed | 2024-12-13T22:29:21Z |
| format | Article |
| id | doaj.art-18da196c7dc64d24bf83d46895909145 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-13T22:29:21Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-18da196c7dc64d24bf83d468959091452022-12-21T23:29:08ZengElsevierAsian Journal of Surgery1015-95842022-01-01451425430The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysisJiaju Lu0Zehui Wu1Gang Liu2Bing Wang3Lianghui Shi4Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, China; Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, China; Corresponding author. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, No.2 Zheshan Street, Jinghu District. Wuhu City, Anhui Province, China.Summary: Background: In this study, we propose an improved Roux-en-Y (RY) surgical method by constructing a proximal jejunum pouch (PP-RY). Postoperative results were evaluated among patients with gastric cancer who underwent PP-RY and standard RY anastomosis. Methods: The clinical data of patients with gastric cancer who underwent laparoscopic total gastrectomy (LTG) in our center from May 2019 to May 2020 were collected retrospectively. We compared the short-term results of patients in the PP-RY and RY groups using 1:1 propensity score matching (PSM). Results: A total of 317 patients were selected, including those who received RY (n = 249) or PP-RY (n = 68) after LTG. After PSM, both groups had a sample size of 68. During the one-year follow-up period, the incidences of postoperative dumping syndrome (5.6%) and reflux esophagitis (14.8%) were significantly lower in the PP-RY group (P = 0.001 and P = 0.010, respectively). Weight loss (6.5 ± 2.0 kg) and albumin decrease (0.2 ± 0.1 g/dl) were significantly lower (P = 0.038 and P < 0.001, respectively), and the prognostic nutritional index (PNI) was significantly higher in the PP-RY group (P = 0.009). In the QLQ-C30 scale, the degree of anorexia in the PP-RY group was significantly lower than that in the RY group (P＜0.05). In the QLQ-STO22 scale, chest and abdomen pain, dietary restriction, and anxiety were significantly lower in the PP-RY group (all P＜0.05). Conclusion: PP-RY can lead to obvious improvements in nutritional status, reduce short-term complications, and improve quality of life (QoL) for patients after LTG.http://www.sciencedirect.com/science/article/pii/S1015958421003742Gastric cancerLaparoscopic total gastrectomyJejunal pouchRoux-en-Y |
| spellingShingle | Jiaju Lu Zehui Wu Gang Liu Bing Wang Lianghui Shi The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis Asian Journal of Surgery Gastric cancer Laparoscopic total gastrectomy Jejunal pouch Roux-en-Y |
| title | The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis |
| title_full | The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis |
| title_fullStr | The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis |
| title_full_unstemmed | The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis |
| title_short | The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis |
| title_sort | clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy a propensity score based analysis |
| topic | Gastric cancer Laparoscopic total gastrectomy Jejunal pouch Roux-en-Y |
| url | http://www.sciencedirect.com/science/article/pii/S1015958421003742 |
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