Abstract:
Objective To compare the effect of double channel anastomosisin laparoscopic resection of proximal gastric cancer in digestive tract reconstruction
Methods Retrospective cohort study the clinical data of 123 patients with early proximal gastric cancer who underwent laparoscopic resection from February 2016 to March 2020. According to different anastomosis techniques，they were divided into tubular group（n=65 cases，esophageal tubular gastric anastomosis）and dual channel group（n=58 cases，dual channel anastomosis）. SPSS 23.0 statistical analysis software was used. Perioperative indicators，gallbladder contraction function，and quality of life measurement scale（EORTC QLQ-C30）scores were expressed as（
±
s），independent
t test was performed. The incidence of complications were tested by
χ2 test.
P<0.05 was considered statistically significant.
Results The operation time of double channel group was longer than that in the tubular group，and the incidence of complications was lower than that of tubular group（P<0.05）；Three months after operation，the gallbladder volume and fasting gallbladder volume in the double channel group were lower than those in the tubular group，and the gallbladder contraction rate and the scores of EORTC QLQ-C30 scale were higher than those in the tubular group（P<0.05）；The nutritional indexes in the two channel group were higher than those in tubular group 3 months after operation（P<0.05）；The proportion of patients with a maximum single feeding volume ≥300 ml at 3 months and 6 months after surgery was higher in the dual-channel group than in the tubular group，and the proportion of patients eating >5 times a day was lower than in the tubular group（P<0.05）. There was no significant difference in intraoperative bleeding，number of lymph node dissections，gastrointestinal reconstruction time，postoperative anal exhaust time，postoperative first eating time and postoperative hospital stay between the two channel group and the tubular group（P>0.05）.
Conclusion Esophageal tubular gastric anastomosis and dual channel anastomosis are both feasible in laparoscopic resection of proximal gastric cancer for digestive tract reconstruction but the latter is more conducive to improve gallbladder contraction function，improve quality of life and reduce postoperative complications.
Key words:
Stomach neoplasms,
Laparoscopic resection of proximal gastric cancer,
Dual-channel anastomosis,
Esophageal tubular gastric anastomosis,
Postoperative complications,
Comparative effectiveness research
Gang Liu, Yun Huang, Chaojun Zhang, Yan Zhang, Xinpu Yuan. Comparison of double channel anastomosis and esophageal tubular gastric anastomosis in gastrointestinal reconstruction after laparoscopic resection of proximal gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(03): 258-262.