Assessment of the functional state of the reconstructed digestive tract after various variants of gastrectomy and proximal gastric resections

The aim of the study is to improve functional results and reduce post-resection disorders in gastric cancer. Material and methods. Functional results of operations were studied in 53 patients with gastric cancer: 28 patients (group 1) had antireflux insertion, while 25 patients (group 2) were operated using standard reconstruction techniques.Results. Two years after surgery, organic changes in esophagoenteroanastomosis were detected in 14.3% of patients in group 1 and in 40.0% of patients in group 2 ( P= 0.059), esophagus - in 3.6% and 32.0%, respectively ( P= 0.009). One year after surgery, there were no differences in the frequency of contrast reflux, and after two years it was observed in 39.2% of patients in group 1 and in 80.0% of patients in group 2 ( P= 0.005). At the same time, in group 1, two years after surgery, the diameter of the anastomosis did not affect the presence or absence of contrast reflux compared to group 2. One year after surgery in group 1 compared to group 2, there was a significant difference in the frequency of reflux of radiopharmaceuticals (RF) (60.7% and 90.2%, respectively, P= 0.011) and timely receipt of RF in the small intestine (71.4% and 28.0%, respectively, P= 0.002) determined in the absence of differences in the median duration of reflux and timely transit through the small and large intestine. Two years after surgery, in group 1, compared with group 2, significant differences were found in the frequency of reflux of RF (39.3% and 80.0%, respectively, P= 0.005), timely intake of RF into the small intestine (85.7% and 36.0%, respectively, p = 0.0002), median duration of reflux (12.3 and 30.0 seconds respectively, P= 0.019) and timely transitthrough the colon (67.8% and 36.0%, respectively, P= 0.029), with no differences in timely transit through the small intestine. In group 1, two years after surgery, the frequency of RF reflux significantly decreased from 60.7% to 39.3% ( P= 0.031), as well as the median of its duration from25.7 to 12.3 seconds ( P= 0.003); in group 2, these indicators did not significantly differ.Conclusions. Two years after surgery, functional results after operations using antireflux inserts significantly exceeded those after interventions using traditional reconstruction methods.