Huang ZN, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Lu J, Chen QY, Cao LL, Lin M, Tu RH, Lin JL. Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life. World J Gastroenterol 2017; 23(39): 7129-7138 [PMID: 29093621 DOI: 10.3748/wjg.v23.i39.7129]
Corresponding Author of This Article
Dr. Chang-Ming Huang, Professor, Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fuzhou 350001, Fujian Province, China. hcmlr2002@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Table 3 Demographic and clinical characteristics of patients in the two groups
All patients
Propensity-matched patients
Group T (n = 51)
Group A (n = 456)
P value
Group T (n = 51)
Group A (n = 102)
P value
Age (mean ± SD, yr)
55.5 ± 12.1
61.6 ± 11.2
< 0.001
55.5 ± 12.1
55.9 ± 11.0
0.916
Gender
< 0.001
1.000
Male
34
345
34
68
Female
17
111
17
34
Charlson comorbidity index
0.281
0.608
0
48
418
48
92
1-2
3
38
3
10
BMI (mean ± SD, kg/m2)
22.5 ± 13.1
22.3 ± 13.5
0.919
22.5 ± 13.1
22.6 ± 12.8
0.965
Tumor size (mean ± SD, cm)
4.5 ± 1.5
4.9 ± 1.3
0.041
4.5 ± 1.5
4.7 ± 1.7
0.142
Tumor location
< 0.001
0.177
Upper third
4
188
4
12
Middle third
34
169
34
76
Whole
13
99
13
14
Histology type
0.453
0.482
Differentiation
47
416
47
97
Undifferentiation
4
40
4
5
Preoperative albumin (mean ± SD, g/L)
40.8 ± 4.3
39.1 ± 5.2
0.025
40.8 ± 4.3
40.6 ± 4.6
0.796
Depth of infiltration (T)
0.174
0.643
T1
15
82
15
23
T2
8
83
8
18
T3
10
135
10
16
T4a
18
166
18
45
Nodal status (N)
0.729
0.534
N0
21
190
21
34
N1
11
77
11
18
N2
5
66
5
10
N3
14
123
14
40
UICC stage
0.319
0.502
I
13
78
13
18
II
17
159
17
40
III
21
219
21
44
Table 4 Operative variables of the patients
All patients
Propensity-matched patients
Group T (n = 51)
Group A (n = 456)
P value
Group T (n = 51)
Group A (n = 102)
P value
Operative time, min (mean ± SD)
209.3 ± 41.0
203.6 ± 49.3
0.427
209.3 ± 41.0
200.5 ± 55.6
0.318
Blood loss, mL (mean ± SD)
48.3 ± 38.5
98.4 ± 149.1
0.017
48.3 ± 38.5
105.4 ± 147.9
0.008
Harvested LNs (mean ± SD)
44.5 ± 15.0
41.2 ± 14.2
0.237
44.5 ± 15.0
42.6 ± 15.2
0.465
Time to first flatus, days (mean ± SD)
3.8 ± 1.2
3.5 ± 1.7
0.220
3.8 ± 1.2
3.6 ± 1.2
0.332
Time to fluid diet, days (mean ± SD)
5.6 ± 1.4
5.6 ± 1.6
1
5.6 ± 1.4
5.5 ± 1.9
0.739
Postoperative days (mean ± SD)
12.6 ± 4.3
14.7 ± 8.9
0.097
12.6 ± 4.3
15.4 ± 8.9
0.035
hospitalization costs, yuan
75450 ± 20038
73308 ± 21932
0.505
75450 ± 20038
70407 ± 13254
0.065
Chemotherapy
33
310
0.635
33
78
0.123
Table 5 Morbidity and mortality associate with anastomosis
All patients
Propensity-matched patients
Group T, % (n = 456)
Group A, % (n = 51)
P value
Group T, % (n = 102)
Group A, % (n = 51)
P value
Morbidity
1 (2.0)
27 (5.9)
0.893
1 (1.9)
6 (11.8)
0.552
Anastomotic fistula
1
22
1
4
Anastomotic hemorrhage
0
1
0
0
Anastomotic obstruction
0
4
0
2
Mortality
0
0
/
0
0
/
Table 6 Constituent items of pain of EORTC-QLQ-C30 and dysphagia of EORTC-QLQ-STO22 as compared between group T and group A
Propensity-matched patients
Group T (n = 44)
Group A (n = 89)
P value
Constituent items of pain of EORTC-QLQ-C30
Have you felt pain?
0.018
Not at all
28
66
A little
12
7
Quite a lot
3
14
Very much
1
2
Have your life affected by pain?
0.271
Not at all
39
73
A little
4
7
Quite a lot
1
9
Very much
0
0
Constituent items of dysphagia of EORTC-QLQ-STO22
Have you felt difficult to eat solid food?
0.039
Not at all
26
31
A little
11
32
Quite a lot
7
21
Very much
0
5
Have you felt difficult to eat liquid of soft food?
0.275
Not at all
38
67
A little
5
15
Quite a lot
1
7
Very much
0
0
Have you felt difficult to drink water?
0.194
Not at all
39
80
A little
5
5
Quite a lot
0
4
Very much
0
0
Citation: Huang ZN, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Lu J, Chen QY, Cao LL, Lin M, Tu RH, Lin JL. Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life. World J Gastroenterol 2017; 23(39): 7129-7138