Effects of two different reconstruction methods of digestive tract after radical total gastrectomy on quality of life and immune nutrition status in patients with gastric cancer / 中华临床营养杂志

ABSTRACT

Objective To compare the quality of life,nutritional status and immune function of gastric cancer patients with digestive tract reconstruction using Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis after radical gastrectomy.Methods 86 patients with gastric cancer were selected from May 2015 to June 2017 with radical total gastrectomy.According to the different ways of the reconstruction of the digestive tract,the patients were divided into URY group (non-severed group,41 patients) and RY group (traditional group,45 patients).The quality of life of the two groups was compared at 1 month,3 months and 6 months after operation.The nutritional status of albumin,prealbumin,transferrin,hemoglobin,retinol binding protein and weight,as well as CD4+ lymphocyte,CD8+ lymphocyte,CD4+/CD8+ ratio,IgG,IgM,IgA and other immune related indexes were observed at pre-operation and 1 month,3 months and 6 months after operation.Results As for quality of life,the score of diet limitation in group URY was significantly lower than that in group RY at 1 month after operation (P＜0.05),and no significant difference at 3 months and 6 months after operation (P＞0.05);As for anxiety,the score of group URY was higher than that in group RY (P＜ 0.05) at 1 month after operation (P＜0.05),and was lower than that in group RY at 3 months and 6 months after operation (P＜0.05).As for dry mouth,group URY was higher than that in group RY (P＜0.05) at 3 months and 6 months after operation (P＜0.05),and the other indexes were not statistically significant (P＞ 0.05).As for the nutritional indexes,prealbumin in the URY group was higher than that in the RY group at 6 months after operation (P＜0.05),and the rest were not statistically significant (P＞0.05).There was no statistical significance in immune indexes between the two groups (P ＞ 0.05).The postoperative hospitalization time of URY group was less than that of RY group (P＜0.05),and the incidence of mild reflux symptoms was lower than that of RY group (P＜0.05).There was no significant difference in the incidence of other complications between the two groups (P＞0.05).Conclusion Except for the length of hospitalization and postoperative complications in which uncut Roux-en-Y anastomosis was superior to Roux-en-Y anastomosis,there is no significant difference in quality of life and nutritional and immune indicators between the two alimentary tract reconstruction methods.