Clinical efficacy and safety of double-channel anastomosis and tubular gastroesophageal anastomosis in gastrectomy

Table 1 Comparison of baseline data between patients with proximal gastric adenocarcinoma in the dual-channel anastomosis group and the tubular gastroesophageal anastomosis group, n (%)

Group	Cases	Age			Gender		Body mass index
		≤ 65 years old	> 65 years old		Male	Female	< 18 kg/m²	18-25 kg/m²	> 25 kg/m²
Dual-channel anastomosis group	50	33 (66.0)	17 (34.0)		35 (70.0	15 (30.0)	1 (2.0)	37 (74.0)	12 (24.0)
Tubular gastroesophageal anastomosis group	49	21 (42.9)	28 (57.1)		41 (83.7)	8 (16.3)	0	34 (69.4)	15 (30.6)
χ2		5.346			2.594		1.392
P value		0.021			0.107		0.577
Group	Cases	American Society of Anesthesiologists Classification			Hypertension		Coronary heart disease		Diabetes
		I	Ⅱ		Yes	No	Yes	No	Yes	No
Dual-channel anastomosis group	50	37 (74.0)	13 (26.0)		18 (36.0)	32 (64.0)	1 (2.0)	49 (98.0)	6 (12.0)	44 (88.0)
Tubular gastroesophageal anastomosis group	49	36 (73.5)	13 (26.5)		16 (32.7)	33 (67.3)	0	49 (100)	6 (12, 2)	43 (87.8)
χ2		0.004			0.123		0.99		0.001
P value		0.952			0.726		0.32		0.97
Group	Cases	Tumor T-stage			Tumor N-stage		Tumor TNM-stage		Tumor diameter
		Tl	T2	T3	NO	N1	I	Ⅱ	< 4 cm	24 cm
Dual-channel anastomosis group	50	36 (72.0)	11 (22.0)	3 (6.0)	46 (92.0)	4 (8.0)	42 (84.0)	8 (16.0)	49 (98.0)	1 (2.0)
Tubular gastroesophageal anastomosis group	49	34 (69.4)	6 (12.2)	9 (18.4)	49 (100)	0	40 (81.6)	9 (18.4)	44 (89.9)	5 (10.2)
χ2		4.518			2.282		0.098		1.662
P value		0.104			0.131		0.755		0.197

Table 2 Comparison of intraoperative and postoperative conditions between the two groups

Group	Cases	Surgical methods		Intraoperative bleeding volume (mL)	Number of lymph nodes resected	Operative time (h)	Hospital stay (d)	Short-term complications after anastomotic surgery (%)
		Laparoscopic	Open					Total	Anastomotic bleeding	Anastomotic leakage	Gastroparesis	Pneumonia	Infect
Dual-channel anastomosis group	50	16 (32.0)	34 (68.0)	200 (100, 300)	17 (15, 21)	4 (3, 4)	16 (15, 18)	5 (10.0)	1	2	1	0	1
Tubular gastroesophageal anastomosis group	49	10 (20.4)	39 (79.6)	200 (100, 200)	20 (16, 25)	3.6 (3.1, 4.0)	14 (13, 18)	4 (8.2)	1	1	1	1	0
Statistics		χ2 = 1.717		Z = 0.245	Z = 1.866	Z = 0.102	Z = 1.463	χ2 = 0.101
P value		0.19		0.807	0.062	0.918	0.144	0.751

Table 3 Comparison of postoperative quality of life scores between the two groups

Group		Dual-channel anastomosis group	Tubular gastroesophageal anastomosis group	Z value	P value
Cases		50	49
Somatic symptoms	Esophageal reflux scale	2.8 (2.3, 4.0)	4.8 (3.8, 5.0)	3.489	< 0.001
	Abdominal pain scale	2.0 (1.3, 3.0)	1.7 (1.3, 2.3)	0.358	0.72
	Eating distress subscale	2.7 (1.7, 3.0)	3.3 (2.7, 4.0)	3.393	0.001
	Digestive dysfunction scale	3.0 (2.5, 3.8)	2.8 (2.0, 3.8)	0.79	0.43
	Diarrhea subscale	1.3 (13, 1.7)	1.3 (13, 1.3)	0.143	0.886
	Constipation subscale	1.3 (1.3, 1.3)	1.3 (1.3, 1.3)	2.004	0.045
	Dumping scale	1.3 (1.3, 13)	3 (1.3, 1.3)	0.802	0.422
	Total symptom scale	2.3 (1.7, 2.7)	2.5 (2.2, 2.9)	2.243	0.025
Other outcome indicators	Increased anal exhaust	3.5 (2.0, 5.0)	3.0 (2.0, 4.0)	2.345	0.019
	Loose stool	2.0 (1.0, 2.0)	2.0 (2.0, 2.0)	2.397	0.017
Living conditions	Changes in body mass	13.7 (6.3, 18.6)	12.9 (8.7, 16.5)	0.042	0.967
	Food intake per meal	6.0 (4.0, 6.0)	5.0 (4.0, 6.0)	1.924	0.054
	Necessity of additional meals and meal quality	5.0 (3.0, 5.0)	5.0 (5.0, 5.0)	1.488	0.137
	Meal quality quantity scale	4.3 (3.7, 4.3)	4.0 (3.3, 4.3)	2.666	0.008
Quality of life	Working ability	2.0 (1.0, 2.0)	2.0 (1.0, 2.0)	1.362	0.173
	Dissatisfied with symptoms	2.0 (1.0, 3.0)	2.0 (2.0, 3.0)	2.127	0.033
	Discontent with dining	2.0 (1.0, 2.0)	2.0 (2.0, 3.0)	3.976	< 0.001
	Dissatisfied with work	1.0 (1.0, 2.0)	2.0 (1.0, 20)	2.279	0.023
	Scale of dissatisfaction	1.7 (13, 2.0)	2.0 (2.0, 2.3)	3.95	< 0.001
	Total measurement of physical health	83.8 (77.5, 88.8)	82.5 (77.5, 88.8)	1.702	0.089
	Overall measurement of mental health	93.8 (87.5, 100.0)	91.7 (83.3, 100.0)	0.412	0.68

Table 4 Comparison of long-term postoperative complications in patients with upper gastric adenocarcinoma, n (%)

Group	Cases	Reflux esophagitis					Anastomotic stenosis	Intestinal obstruction	Delayed gastric emptying
		Total	A	B	C	D
Dual channel matching group	50	2 (4.0)	2 (4.0)	0	0	0	6 (12.0)	1 (2.0)	0
Tubular gastroesophageal anastomosis group	49	13 (26.5)	6 (12.2)	5 (10.2)	1 (2.0)	1 (2.0)	12 (24.5)	0	2 (4.1)
Statistical value		χ2 = 13.507		Z = 3.177			χ2 = 2.595	χ2 < 0.001	χ2 = 0.531
P value		0.009		0.001			0.107	> 0.999	0.466