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BackgroundUncut Roux-en-Y (U-RY) has been increasingly used in radical gastric cancer surgery, but it is still in the exploratory stage. There is insufficient evidence for its long-term efficacy.MethodsFrom January 2012 to October 2017, a total of 280 patients diagnosed with gastric cancer were eventually included in this study. Patients undergoing U-RY were assigned to the U-RY group, while patients undergoing BillrothII with Braun (B II + Braun) were assigned to the B II + Braun group.ResultsThere were no significant differences between the two groups in operative time, intraoperative blood loss, postoperative complications, first exhaust time, time to liquid diet, and length of postoperative hospital stay (all P > 0.05). Endoscopic evaluation was performed 1 year after surgery. Compared to B II + Braun group, the uncut Roux-en-Y group had significantly lower incidences of gastric stasis [16.3% (15/92) vs. 28.2% (42/149), χ2 = 4.448, P = 0.035], gastritis [13.0% (12/92) vs. 24.8% (37/149), χ2 = 4.880, P = 0.027] and bile reflux [2.2% (2/92) vs. 20.8% (11/149), χ2 = 16.707, P

Objective To compare the treatment effects and complications of three reconstruction procedures in patients after radical gastrectomy. Methods A total of 194 patients with radical gastrectomy were selected and divided into the U-RY group (Uncut Roux-en-Y anastomosis, 69 cases), the B Ⅰ group (Billroth-Ⅰ modified delta-shaped anastomosis, 65 cases) and the B Ⅱ +Braun group (Billroth- Ⅱ +Braun anastomosis, 60 cases) according to the gastrointestinal reconstruction methods. The basic data of the three groups were matched by propensity score matching. The surgical status, postoperative recovery status, intestinal barrier function [diamine oxidase (DAO), D-lactic acid, endotoxin (ETX)], inflammatory stress indicators [interleukin-6 (IL-6), interleukin-10 (IL-10), 8-iso-prostaglandin F2α (8-iso-PGF2α), heme oxygenase-1 (HO-1)] and complications were compared between the three groups. Results Before propensity score matching, gender and age were not evenly distributed in the three groups (P＜0.05). After matching, 147 cases of 194 patients were successfully matched, with 49 cases in each group. There were no significant differences in general data between the three groups (P＞0.05). The surgical time increased successively in the B Ⅰ group, the B Ⅱ+Braun group and the U-RY group (P＜0.05). The intraoperative blood loss, postoperative bowel sound recovery time, first exhaust time, extubation time, eating time, first defecation time and hospital stay were less or shorter in the B Ⅰ group than those in the B Ⅱ+Braun group and the U-RY group (P＜0.05), but there were no significant differences in the above indicators between the B Ⅱ+Braun group and the U-RY group (P＞0.05). At 3 d after surgery, the levels of DAO, D-lactic acid and ETX were significantly lower in the B Ⅰ group than those of the U-RY group and the B Ⅱ+Braun group, while the levels of IL-6, IL10, 8-iso-PGF2α and HO-1 were higher compared with those in the U-RY group and the B Ⅱ+Braun group (P＜0.05). There were no significant differences in the above indicators between the U-RY group and the B Ⅱ+Braun group (P＞0.05). There were no significant differences in incidence rates of complications between the three groups (P＞0.05). Conclusion Billroth- Ⅰ modified delta-shaped anastomosis has the advantages of shorter surgical duration, less blood loss, faster recovery and smaller effect on the intestinal barrier compared to Billroth- Ⅱ+Braun anastomosis and Uncut Roux-en-Y anastomosis, but the latter two are more suitable for more indications and have milder inflammatory stimulation, and Uncut Roux-en-Y anastomosis can reduce postoperative reflux. [ABSTRACT FROM AUTHOR]