Volume 23 Issue 1
Jan.  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(1): 45-49
WANG Mingqing, SHENG Weiwei, CAO Guodong, XIA Guozhi, GENG Qilong, XIONG Maoming, HU Kongwang. Analysis of the safety and efficacy of proximal gastrectomy of esophageal-jejunal π-type anastomosis and circular anastomosis[J]. Chinese Journal of General Practice, 2025, 23(1): 45-49. doi: 10.16766/j.cnki.issn.1674-4152.003832
Citation: WANG Mingqing, SHENG Weiwei, CAO Guodong, XIA Guozhi, GENG Qilong, XIONG Maoming, HU Kongwang. Analysis of the safety and efficacy of proximal gastrectomy of esophageal-jejunal π-type anastomosis and circular anastomosis[J]. Chinese Journal of General Practice, 2025, 23(1): 45-49. doi: 10.16766/j.cnki.issn.1674-4152.003832
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Analysis of the safety and efficacy of proximal gastrectomy of esophageal-jejunal π-type anastomosis and circular anastomosis

doi: 10.16766/j.cnki.issn.1674-4152.003832
  • 1.

    Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, China

Funds:

 2023zhyx-B19

 2021xjjyxm34

 2020xsxxkc247

 202210366008

  • Received Date: 2024-04-18
    Available Online: 2025-02-13
    Abstract
  •   Objective  Compare the perioperative and postoperative outcomes of two different digestive reconstructions: improved endoscopic esophago-jejunal π-anastomosis and open circular anastomosis in proximal gastrectomy. We investigated the safety and effectiveness of improved π-anastomosis combined with dual channel anastomosis in proximal gastrectomy.  Methods  A retrospective analysis was conducted on the clinical data of 63 cases of gastric cancer who underwent laparoscopic or open proximal gastrectomy, dual-channel anastomosis in the Department of Gastroenterology at the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2023. Among them, 24 cases underwent open esophagojejunal circular anastomosis (circular anastomosis group); 39 cases of full endoscopic esophagojejunal modified π-type anastomosis were selected (π anastomosis group). Compare the clinical data, perioperative recovery, and postoperative complications of two groups of patients to evaluate the safety and efficacy of the improved π-type anastomosis technique.  Results  There were no differences between the π-type anastomosis group and the round astomosis group in terms of preoperative baseline data, number of lymph nodes dissected during operation, cutting edge condition, intraoperative blood loss, operation time and anastomosis time, and postoperative related complication (P>0.05), but the length of the incision [(4.92±0.53) cm vs. (14.33±1.80) cm, P < 0.001], the time of the first activity on the ground [(1.07±0.27) d vs. (1.91±0.58) d, P < 0.001], first exhaust time [(2.17±0.38) d vs. (2.91±0.58) d, t=4.652, P=0.039], the time to return to a full liquid diet, the length of postoperative hospital stay, NRS score on the third postoperative day, the incision infection, and overall postoperative complication grading, these were significant statistical differences (P < 0.05).  Conclusion  The combined esophageal-jejuno-π anastomosis and open circular anastomosis in the double-channel gastrointestinal reconstruction of proximal gastrectomy are equally safe and effective, while the π-type anastomosis is less invasive and has a faster recovery, which is a safe, feasible and worthwhile strategy for gastrointestinal reconstruction.

     

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