A 3-year follow-up study of uncut Roux-en-Y reconstruction: clinical results and outcomes

Chung, Jae Hun; Im, Dong Won; Choi, Cheol Woong; Kim, Su Jin; Hwang, Sun-Hwi; Lee, Si-Hak

doi:10.1007/s00464-022-09198-7

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…Chung JH's endoscopic ndings at 6-32 months demonstrated that the proportion of grade 2 and 3 residual gastritis increased from 73.0-86.1% in the BII + B group, and the incidence of re ux esophagitis rose from 1-15.7% [39]. Similarly, Choi C's endoscopic ndings at year 2 postoperatively showed increased bile re ux and an aggravated degree of residual gastritis in the BII + B group compared to year 1, with signi cantly higher re ux esophagitis compared to the R-Y group [40].…”

Section: Discussionmentioning

confidence: 99%

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Chen

Huang

Wang

et al. 2023

Preprint

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BACKGROUND: The controversy surrounding Roux-en-Y and Billroth II with Braun anastomosis as an anti-bile reflux procedure after distal gastrectomy has persisted. Recent studies have demonstrated their efficacy, but the long-term outcomes and postoperative quality of life (QoL) among patients have yet to be evaluated. Therefore, we compared the short-term and long-term outcomes of the two procedures as well as QoL.METHODS The clinical data of 151 patients who underwent total laparoscopic distal gastrectomy at the Second Hospital of Fujian Medical University from January 2016 to December 2019 were retrospectively analyzed. Of these, 57 cases with Roux-en-Y anastomosis (R-Y group) and 94 cases with Billroth II with Braun anastomosis were included (BII + B group). Operative and postoperative conditions, early and late complications, endoscopic outcomes at year 1 and year 3 after surgery, nutritional indicators, and quality of life scores at year 3 postoperatively were compared between the two groups.RESULTS The R-Y group recorded a significantly longer operative time (194.65 ± 21.52 min vs. 183.88 ± 18.02 min) and anastomotic time (36.96 ± 2.43 min vs. 27.97 ± 3.74 min) compared to the BII + B group (P < 0.05). However, no other significant differences were observed in terms of blood loss or postoperative conditions (P > 0.05). Both groups showed comparable rates of early and late complications. Endoscopic findings indicated similar food residuals at years 1 and 3 postsurgery for both groups. The R-Y group had a lower occurrence of residual gastritis and bile reflux at year 1 and year 3 after surgery, with a statistically significant difference (P < 0.001). Reflux esophagitis was not significantly different between the R-Y and BII + B groups in year 1 after surgery, but the R-Y group had a lower incidence than the BII + B group in year 3 after surgery (P = 0.023). Nutritional outcomes at 3 years after surgery did not differ significantly between the two groups (P > 0.05). Quality of life scores measured by the QLQ-C30 scale were not significantly different between the two groups. However, on the QLQ-STO22 scale, the reflux score was significantly lower in the R-Y group than in the BII + B group (0 [0, 0] vs. 5.56 [0, 11.11]) (P = 0.003). The rest of the scores were not significantly different (P > 0.05).CONCLUSION Both R-Y and B II + B are equally safe and efficient for TLDG. Nevertheless, R-Y reduces the incidence of residual gastritis, bile reflux, and reflux esophagitis, as well as postoperative reflux symptoms, and provides a better quality of life for patients.

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Section: Discussionmentioning

confidence: 99%

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Chen

Huang

Wang

et al. 2023

Preprint

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“…U-RY reconstruction is a modification of BII + Braun anastomosis, which has an additional staple line across the afferent limb to block bile reflux. In terms of quality of life 1 year after surgery, the score of pain and reflux symptoms in the U-RY group was better than that in the BII + Braun group, indicating that it could significantly improve the quality of life of patients after surgery (8,9). Quality of life has always been regarded as one of the important indicators for measuring the quality of life of cancer patients (10).…”

Section: Discussionmentioning

confidence: 99%

Long-Term outcomes of uncut roux-en-Y anastomosis in laparoscopic distal gastrectomy: A retrospective analysis

Zhu

Zhou²,

Shen³

et al. 2023

Front. Surg.

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BackgroundUncut Roux-en-Y (U-RY) has been increasingly used in radical gastric cancer surgery, but it is still in the exploratory stage. There is insufficient evidence for its long-term efficacy.MethodsFrom January 2012 to October 2017, a total of 280 patients diagnosed with gastric cancer were eventually included in this study. Patients undergoing U-RY were assigned to the U-RY group, while patients undergoing BillrothII with Braun (B II + Braun) were assigned to the B II + Braun group.ResultsThere were no significant differences between the two groups in operative time, intraoperative blood loss, postoperative complications, first exhaust time, time to liquid diet, and length of postoperative hospital stay (all P > 0.05). Endoscopic evaluation was performed 1 year after surgery. Compared to B II + Braun group, the uncut Roux-en-Y group had significantly lower incidences of gastric stasis [16.3% (15/92) vs. 28.2% (42/149), χ2 = 4.448, P = 0.035], gastritis [13.0% (12/92) vs. 24.8% (37/149), χ2 = 4.880, P = 0.027] and bile reflux [2.2% (2/92) vs. 20.8% (11/149), χ2 = 16.707, P < 0.001], and the differences were statistically significant. The questionnaire was completed 1 year after surgery,the QLQ-STO22 scores showed that, the uncut Roux-en-Y group had a lower pain score(8.5 ± 11.1 vs. 11.9 ± 9.7, P = 0.009) and reflux score(7.9 ± 8.5 vs. 11.0 ± 11.5, P = 0.012), and the differences were statistically significant (P < 0.05). However, there was no significant difference in overall survival (P = 0.688) and disease-free survival (P = 0.505) between the two groups.ConclusionUncut Roux-en-Y has the advantages of better safety, better quality of life and fewer complications, and is expected to be one of the best methods for digestive tract reconstruction.

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Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer

Cai,

Mu,

et al. 2024

Cochrane Database of Systematic Reviews

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A 3-year follow-up study of uncut Roux-en-Y reconstruction: clinical results and outcomes

Cited by 6 publications

References 23 publications

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Long-Term outcomes of uncut roux-en-Y anastomosis in laparoscopic distal gastrectomy: A retrospective analysis

Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer

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