Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study

Abstract Background Uncut Roux-en-Y (URY) effectively alleviates the prevalent complexities connected with RY, such as Roux-en-Y stasis syndrome (RSS). Nevertheless, for gastric cancer (GC) patients, it is still controversial whether URY has an impact on long-term prognosis and whether it has fewer...

Full description

Saved in:
Bibliographic Details
Main Authors: Yizhen Chen, Yuanyuan Zheng, Song Tan, Yifan Chen, Tao Zheng, Shaolin Liu, Yulong Mi, Shentao Lin, Changshun Yang, Jian Jiang, Weihua Li
Format: Article
Language:English
Published: BMC 2023-09-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-023-03154-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849434275838951424
author Yizhen Chen
Yuanyuan Zheng
Song Tan
Yifan Chen
Tao Zheng
Shaolin Liu
Yulong Mi
Shentao Lin
Changshun Yang
Jian Jiang
Weihua Li
author_facet Yizhen Chen
Yuanyuan Zheng
Song Tan
Yifan Chen
Tao Zheng
Shaolin Liu
Yulong Mi
Shentao Lin
Changshun Yang
Jian Jiang
Weihua Li
author_sort Yizhen Chen
collection DOAJ
description Abstract Background Uncut Roux-en-Y (URY) effectively alleviates the prevalent complexities connected with RY, such as Roux-en-Y stasis syndrome (RSS). Nevertheless, for gastric cancer (GC) patients, it is still controversial whether URY has an impact on long-term prognosis and whether it has fewer afferent loop recanalization. Therefore, compare whether URY and RY have differences in prognosis and long-term complications of GC patients undergoing totally laparoscopic gastrectomy (TLG). Methods We analyzed the data of patients who underwent TLG combined with digestive tract reconstruction from dual-center between 2016 and 2022. Only patients undergoing URY and RY were selected for analysis. Relapse-free survival (RFS) and overall survival (OS) were estimated. Bias between the groups was reduced by propensity score matching (PSM). The Cox proportional hazard regression model was used to further analyze the influence of URY on prognosis. Results Two hundred forty two GC patients were enrolled. The URY had significantly shorter operation time, liquid food intake time, and in-hospital stays than the RY (P < 0.001). The URY had fewer long-term and short-term postoperative complications than the RY, especially with regard to RSS, reflux esophagitis, and reflux gastritis. The 3-year and 5-year OS of the URY group and the RY group before PSM: 87.5% vs. 65.6% (P < 0.001) and 81.4% vs. 61.7% (P = 0.001). PSM and Cox multivariate analysis confirmed that compared to RY, URY can improve the short-term and long-term prognosis of GC patients. Conclusion TLG combined with URY for GC, especially for advanced, older, and poorly differentiated patients, may promote postoperative recovery and improve long-term prognosis.
format Article
id doaj-art-735874dbb6fd48b8b0b6dfa9a6fadeb3
institution Kabale University
issn 1477-7819
language English
publishDate 2023-09-01
publisher BMC
record_format Article
series World Journal of Surgical Oncology
spelling doaj-art-735874dbb6fd48b8b0b6dfa9a6fadeb32025-08-20T03:26:43ZengBMCWorld Journal of Surgical Oncology1477-78192023-09-0121111210.1186/s12957-023-03154-yEfficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective studyYizhen Chen0Yuanyuan Zheng1Song Tan2Yifan Chen3Tao Zheng4Shaolin Liu5Yulong Mi6Shentao Lin7Changshun Yang8Jian Jiang9Weihua Li10Shengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityDepartment of Surgical Oncology, Fujian Provincial HospitalDepartment of Surgical Oncology, Fujian Provincial HospitalDepartment of Surgical Oncology, Fujian Provincial HospitalThe School of Public Health, Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityAbstract Background Uncut Roux-en-Y (URY) effectively alleviates the prevalent complexities connected with RY, such as Roux-en-Y stasis syndrome (RSS). Nevertheless, for gastric cancer (GC) patients, it is still controversial whether URY has an impact on long-term prognosis and whether it has fewer afferent loop recanalization. Therefore, compare whether URY and RY have differences in prognosis and long-term complications of GC patients undergoing totally laparoscopic gastrectomy (TLG). Methods We analyzed the data of patients who underwent TLG combined with digestive tract reconstruction from dual-center between 2016 and 2022. Only patients undergoing URY and RY were selected for analysis. Relapse-free survival (RFS) and overall survival (OS) were estimated. Bias between the groups was reduced by propensity score matching (PSM). The Cox proportional hazard regression model was used to further analyze the influence of URY on prognosis. Results Two hundred forty two GC patients were enrolled. The URY had significantly shorter operation time, liquid food intake time, and in-hospital stays than the RY (P < 0.001). The URY had fewer long-term and short-term postoperative complications than the RY, especially with regard to RSS, reflux esophagitis, and reflux gastritis. The 3-year and 5-year OS of the URY group and the RY group before PSM: 87.5% vs. 65.6% (P < 0.001) and 81.4% vs. 61.7% (P = 0.001). PSM and Cox multivariate analysis confirmed that compared to RY, URY can improve the short-term and long-term prognosis of GC patients. Conclusion TLG combined with URY for GC, especially for advanced, older, and poorly differentiated patients, may promote postoperative recovery and improve long-term prognosis.https://doi.org/10.1186/s12957-023-03154-yGastric cancerTotally laparoscopic gastrectomyUncut Roux-en-YDigestive tract reconstruction
spellingShingle Yizhen Chen
Yuanyuan Zheng
Song Tan
Yifan Chen
Tao Zheng
Shaolin Liu
Yulong Mi
Shentao Lin
Changshun Yang
Jian Jiang
Weihua Li
Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
World Journal of Surgical Oncology
Gastric cancer
Totally laparoscopic gastrectomy
Uncut Roux-en-Y
Digestive tract reconstruction
title Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
title_full Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
title_fullStr Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
title_full_unstemmed Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
title_short Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study
title_sort efficacy and safety of totally laparoscopic gastrectomy with uncut roux en y for gastric cancer a dual center retrospective study
topic Gastric cancer
Totally laparoscopic gastrectomy
Uncut Roux-en-Y
Digestive tract reconstruction
url https://doi.org/10.1186/s12957-023-03154-y
work_keys_str_mv AT yizhenchen efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT yuanyuanzheng efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT songtan efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT yifanchen efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT taozheng efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT shaolinliu efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT yulongmi efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT shentaolin efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT changshunyang efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT jianjiang efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy
AT weihuali efficacyandsafetyoftotallylaparoscopicgastrectomywithuncutrouxenyforgastriccanceradualcenterretrospectivestudy