Related Experiment Video
Updated: Aug 6, 2026
03:32
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
[Comparative study on three types of digestive reconstruction after total gastrectomy]
Hong-bo Wei1, Bo Wei, Zong-heng Zheng
1Department of Gastrointestinal Surgery, The Thir d Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China. drwhb@21cn.com
Summary
Orr-type Roux-en-Y esophagojejunostomy is recommended for digestive reconstruction after total gastrectomy for gastric cancer. This method effectively avoids reflux esophagitis and simplifies the procedure, improving patient outcomes.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Digestive System Reconstruction
Background:
- Total gastrectomy is a standard treatment for gastric malignancy.
- Digestive reconstruction following total gastrectomy is crucial for patient recovery and quality of life.
- Various reconstruction techniques exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To investigate and compare different methods of digestive reconstruction after total gastrectomy for gastric cancer.
- To evaluate the efficacy and safety of various reconstruction techniques in terms of surgical outcomes, patient symptoms, nutritional status, and survival rates.
Main Methods:
- A comparative study involving 189 patients undergoing total gastrectomy for gastric carcinoma.
- Three distinct types of digestive reconstruction were performed: Orr-type Roux-en-Y, P-type, and Moynihan-type esophagojejunostomy.
- Key parameters assessed included operating time, morbidity, mortality, food intake, digestive symptoms, nutritional markers (hemoglobin, total protein), and survival rates at 1, 3, and 5 years.
Main Results:
- No significant differences were observed among the three reconstruction methods regarding operative morbidity, mortality, postoperative food intake, nutritional status, or incidence of diarrhea and dumping syndrome.
- Overall 1-, 3-, and 5-year survival rates were 75.3%, 38.2%, and 20.5%, respectively, with no significant variations between groups.
- Orr-type and P-type esophagojejunostomy demonstrated superior anti-esophageal reflux capabilities compared to the Moynihan-type anastomosis (P<0.01).
- Orr-type reconstruction was found to be simpler, with shorter operating times and fewer complications than P-type reconstruction.
Conclusions:
- Orr-type Roux-en-Y esophagojejunostomy is a recommended and adaptable method for digestive reconstruction post-total gastrectomy for gastric cancer.
- This technique effectively prevents reflux esophagitis, supports better nutritional status, and enhances the quality of life for patients.
- The procedure's simplicity and reduced complication rate make it a favorable choice for surgeons and patients.