Application of modified Roux-en-Y digestive tract reconstruction in total gastrectomy for patients with gastric cancer

Table 1 Comparison of general data between the two groups of patients, n (%)

Characteristics	Orr group (n = 54)	Modified group (n = 43)	χ2/F	P value
Sex	-	-	0.001	0.998
Male (cases)	41 (75.9)	39 (90.7)	-	-
Female (cases)	13 (24.1)	4 (8.7)	-	-
Age (year), mean ± SD	62.38 ± 11.84	68.39 ± 10.11	2.272	0.110
BMI
TNM staging (cases)	-	-	0.001	0.998
I	11 (20.4)	4 (9.3)	-	-
II	5 (9.3)	6 (14.0)	-	-
III	38 (70.4)	33 (76.7)	-	-
Tumor pathological classification (cases)	-	-	0.375	0.701
Nodule type	9 (16.7)	4 (9.3)	-	-
Ulceration type	31 (57.4)	28 (65.1)	-	-
Diffuse invasive	14 (25.9)	11 (25.6)	-	-
Tumor diameter (cases)	-	-	0.008	0.991
≤ 1 cm	11 (20.4)	7 (16.3)	-	-
1-4 cm	16 (29.6)	11 (25.6)	-	-
> 4 cm	27 (50.0)	25 (58.1)	-	--
Infiltrative depth (cases)	-	-	0.001	0.998
T1	11 (20.4)	2 (4.7)	-	-
T2	2 (3.7)	4 (9.3)	-	-
T3	7 (12.9)	4 (9.3)	-	-
T4	34 (63.0)	33 (76.7)	-	-
Lymphatic metastasis (cases)	-	-	0.007	0.992
N0	25 (46.3)	17 (39.5)	-	-
N1	7 (13.0)	6 (13.9)	-	-
N2	9 (16.7)	9 (21.0)	-	-
N3	13 (24.0)	11 (25.6)	-	-

BMI: Body mass index; Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group; SD: Standard deviation; TNM: Tumor-node-metastasis.

Table 2 Comparison of perioperative indicators between the two groups of patients, mean ± SD

Characteristics	Orr group	Modified group	F value	P value
Operation time (minute)	211.7 ± 19.66	160.9 ± 9.44	163.8	0.000
Digestive tract reconstruction time (minute)	52.25 ± 7.79	21.46 ± 2.77	502.3	0.000
Intraoperative blood loss (mL)	235.4 ± 79.12	215.42 ± 49.61	1.324	0.269
Postoperative exhaust time (day)	2.22 ± 1.30	2.15 ± 1.36	0.033	0.966
Postoperative fasting time (day)	2.25 ± 0.85	2.61 ± 0.49	0.086	0.916
Hospital stay after operation (day)	12.38 ± 5.77	10.04 ± 3.40	2.862	0.060
Total cost of hospitalization (million RMB)	6.286 ± 1.546	5.795 ± 1.338	1.755	0.176
Cases	54	43	-	-

Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group; RMB: Renminbi.

Table 3 Recent postoperative complications of the two groups of patients, n (%)

Characteristics	Orr group	Modified group	χ2	P value
Anastomotic bleeding	1 (1.8)	1 (2.3)	0.013	0.986
Anastomotic leakage	5 (9.3)	1 (2.3)	0.016	0.983
Anastomotic stricture	3 (5.5)	2 (4.6)	0.015	0.984
Anastomotic ischemia	5 (9.3)	0	0.014	0.985
Duodenal stump fistula	2 (3.7)	0	0.013	0.986
Cases	16 (29.6)	4 (9.3)	0.027	0.973

Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group.

Table 4 Long-term postoperative complications of the two groups of patients, n (%)

Characteristics	Orr group	Modified group	χ2	P value
Roux stasis syndrome	2 (3.7)	0	0.013	0.986
Reflux esophagitis	6 (11.1)	0	0.017	0.0321
Stomal ulcer	7 (13.0)	0	0.018	0.0161
Bile duct stone	4 (7.4)	3 (7.0)	0.017	0.982
Diarrhea	5 (9.3)	2 (9.3)	0.017	0.982
Ileus	8 (14.8)	2 (4.6)	0.019	0.981
Cases	32 (59.3)	7 (20.9)	0.110	0.899

¹After Bonferroni correction, the P value was obtained by Fisher’s exact probability method.

Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group.

Table 5 Comparison of short-term and long-term complications between the two groups of patients

Characteristics	Recent complications	Long-term complication
Orr group-modified group P value	0.021	0.000

After Bonferroni correction, the P value was obtained by Fisher’s exact probability method. Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group.

Table 6 Comparison of nutritional indexes between the two groups at 1 month, 3 month, and 6 months after the operation, mean ± SD

Characteristics	Orr group	Modified group	F value	P value
Weight loss (kg)
1 month after operation	6 (2-12.5)	4.5 (2-7.5)	15.10	0.000
3 months after operation	3.5 (1.5-4.5)	1 (0.5-3)	7.05	0.001
6 months after operation	2 (1-2.5)	1 (0.5-1.5)	2.91	0.060
Hemoglobin (g/L)
1 month after operation	99.4 ± 14.40	112.1 ± 18.37	6.41	0.002
3 months after operation	101.3 ± 15.73	110.0 ± 15.97	3.88	0.025
6 months after operation	106.9 ± 14.62	116.3 ± 15.94	2.76	0.052
Serum total protein (g/L)
1 month after operation	61.4 ± 6.93	64.9 ± 7.05	1.87	0.161
3 months after operation	64.8 ± 6.29	67.9 ± 5.45	2.25	0.112
6 months after operation	67.7 ± 7.07	68.8 ± 5.89	0.55	0.575
Serum albumin (g/L)
1 month after operation	32.3 ± 5.44	34.3 ± 4.80	2.05	0.136
3 months after operation	34.5 ± 4.53	34.9 ± 4.10	2.57	0.083
6 months after operation	36.8 ± 4.31	36.0 ± 3.08	0.82	0.444

Modified group: Modified Roux-en-Y reconstruction group; Orr group: Roux-en-Y reconstruction group.