Scholarlink

Background <p>The optimal reconstruction method after laparoscopic distal gastrectomy (LDG) for gastric cancer remains controversial. This study evaluates the novel approach of subtotal gastrectomy with preservation of a small remnant stomach (SRS) combined with uncut Roux-en-Y (URY) reconstruction, focusing on surgical feasibility, complications, and nutritional outcomes.</p> Methods <p>A retrospective analysis of patients undergoing LDG (2017–2023) was conducted. To minimize selection bias between the URY (n = 175) and conventional Roux-en-Y (RY) (n = 69) groups, we performed 1:1 propensity score matching (PSM). Subgroup analysis was also conducted on URY patients, comparing those with SRS (n = 33) to those with a conventional remnant stomach (CRS) (n = 142), with PSM applied to this comparison as well.</p> Results <p>After PSM, the baseline characteristics of the URY and RY groups (n = 49 each) were well-balanced. In the matched cohort, the URY group demonstrated significantly shorter operation time, less intraoperative blood loss, and shorter postoperative hospital stays compared to the RY group. Similarly, after matching, perioperative and nutritional outcomes were comparable between the SRS and CRS subgroups (n = 23 each).</p> Conclusion <p>After adjusting for baseline confounders using PSM, URY reconstruction is associated with significant surgical advantages over conventional RY. Furthermore, preserving an SRS with URY reconstruction is a safe, feasible, and surgically efficient approach, yielding short-to-intermediate term outcomes comparable to those with a conventional remnant.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Uncut Roux-en-Y for very small remnant stomach in gastric cancer: surgical advantages and nutritional outcomes

  • 期刊论文

  • 发表日期：

    2025年8月25日

查看全文
  • Wen-qi Hong,
  • Ren-hao Hu,
  • Xi-mao Cui,
  • Xiao-hua Jiang,
  • Shun Zhang

摘要

Background

The optimal reconstruction method after laparoscopic distal gastrectomy (LDG) for gastric cancer remains controversial. This study evaluates the novel approach of subtotal gastrectomy with preservation of a small remnant stomach (SRS) combined with uncut Roux-en-Y (URY) reconstruction, focusing on surgical feasibility, complications, and nutritional outcomes.

Methods

A retrospective analysis of patients undergoing LDG (2017–2023) was conducted. To minimize selection bias between the URY (n = 175) and conventional Roux-en-Y (RY) (n = 69) groups, we performed 1:1 propensity score matching (PSM). Subgroup analysis was also conducted on URY patients, comparing those with SRS (n = 33) to those with a conventional remnant stomach (CRS) (n = 142), with PSM applied to this comparison as well.

Results

After PSM, the baseline characteristics of the URY and RY groups (n = 49 each) were well-balanced. In the matched cohort, the URY group demonstrated significantly shorter operation time, less intraoperative blood loss, and shorter postoperative hospital stays compared to the RY group. Similarly, after matching, perioperative and nutritional outcomes were comparable between the SRS and CRS subgroups (n = 23 each).

Conclusion

After adjusting for baseline confounders using PSM, URY reconstruction is associated with significant surgical advantages over conventional RY. Furthermore, preserving an SRS with URY reconstruction is a safe, feasible, and surgically efficient approach, yielding short-to-intermediate term outcomes comparable to those with a conventional remnant.