To investigate the impact of anastomosis with a loop and the Roux-en-Y anastomosis on the quality of life of patients after total gastrectomy, and to provide a reference for the selection of clinical surgical methods.

A total of 495 patients with gastric cancer who underwent total gastrectomy from January 2022 to December 2023 were included. According to the different methods of digestive tract reconstruction, the patients were divided into the loop anastomosis group (with loop anastomosis, n = 40) and the Roux-en-Y anastomosis group (with Roux-en-Y anastomosis, n=455). To control confounding factors between the groups and reduce the selection bias in the retrospective study, this study used propensity score matching (PSM) to match the patients in the two groups. The data were based on the cohort after PSM matching (n=80). The perioperative indicators, complications, and the Postoperative Gastric Resection Syndrome Assessment Scale-45 (PGSAS-45) score at 1 year after gastric resection were compared between the two groups using the χ² test or t test. P<0.05 was considered statistically significant.

The operation time of the loop anastomosis group was significantly shorter than that of the Roux-en-Y group, and the time to start liquid diet and the time to remove the drainage tube were shorter in the loop anastomosis group than in the Roux-en-Y group, but the duration of gastric tube retention was longer (P<0.05). In the PGSAS-45 scale, the esophageal reflux scale score of the Roux-en-Y group was better than that of the loop anastomosis group (P<0.05).

Both anastomosis with a loop and Roux-en-Y anastomosis are safe and feasible after total gastrectomy, and the overall quality of life is similar. The loop anastomosis is conducive to early postoperative recovery, while the Roux-en-Y anastomosis has a greater advantage in controlling esophageal reflux. Clinicians should choose the surgical method based on the individual circumstances of the patients.