Application progress of uncut Roux-en-Y anastomosis in digestive tract reconstruction after distal gastrectomy of gastric cancer

Abstract

Digestive tract reconstruction is an important part of gastric carcinoma operation as well as tumor resection and lymph node dissection. Surgeons are seeking the optimal reconstruction method that reduces the occurrence of complications and maintains better quality of postoperative life extremely. Uncut Roux-en-Y anastomosis is a modified procedure in which an artificial jejunal occlusion is devised to avoid Roux stasis syndrome based on Billroth II and Braun′s anastomosis. Compared to the conventional Roux-en-Y anastomosis, the uncut Roux-en-Y anastomosis retains the advantage of preventing biliary and pancreatic secretions reflux, furthermore, it can decrease the symptoms associated with Roux stasis owing to the abnormal myoelectrical conduction of Roux limb. Because the early studies indicated that there was higher incidence of dehiscence or recanalization of the jejunal occlusion, the uncut Roux-en-Y anastomosis has not been widely applied. Since jejunal occlusion has been optimized recently, the uncut Roux-en-Y reconstruction may be an optional and appropriate method of digestive tract reconstruction after distal gastrectomy. Key words: Gastric neoplasms; Radical resection; Uncut Roux-en-Y anastomosis