Long-term functional outcomes of Roux-en-Y versus Billroth I reconstructions after laparoscopic distal gastrectomy for gastric cancer: a propensity-score matching analysis

Okuno, Keisuke; Nakagawa, Masatoshi; Kojima, Kazuyuki; Kanemoto, Emi; Gokita, Kentaro; Tanioka, Toshiro; Inokuchi, Mikito

doi:10.1007/s00464-018-6192-2

Cited by 21 publications

(25 citation statements)

References 22 publications

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“…Additionally, the incidence of delayed gastric emptying seen in Roux stasis syndrome did not differ between the two groups and was shown to be less problematic long‐term, after surgery. Conversely, reflux esophagitis on endoscopy was more common 5 years after BI, as in previous reports 11,13 . However, few patients required medication for esophagitis, and there was no difference in reflux symptoms between the two groups in the gastrointestinal dysfunction questionnaire survey, using DAUGS 20; therefore, reflux may not be a clinically significant problem.…”

Section: Discussionsupporting

confidence: 61%

“…Conversely, reflux esophagitis on endoscopy was more common 5 years after BI, as in previous reports. 11,13 However, few patients required medication for esophagitis, and there was no difference in reflux symptoms between the two groups in the gastrointestinal dysfunction questionnaire survey, using DAUGS 20; therefore, reflux may not be a clinically significant problem.…”

Section: Discussionmentioning

confidence: 97%

“…Several retrospective studies have compared BI and RY after distal gastrectomy. 10,11 This study provides valuable data because it involved a 5-year long-term follow-up in a large number of prospectively randomized cases and because we investigated QOL in addition to long-term postoperative weight loss and complications.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of 5‐year postoperative outcomes after Billroth I and Roux‐en‐Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi‐institutional randomized controlled trial

Kimura

Mikami

Yamasaki

et al. 2020

Annals of Gastroent Surgery

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Aim We previously reported in a randomized controlled trial that Billroth I and Roux‐en‐Y reconstructions were generally equivalent regarding body weight change and nutritional status 1 year after distal gastrectomy for gastric cancer. We describe the long‐term follow‐up data 5 years after distal gastrectomy. Methods We analyzed consecutive gastric cancer patients who were randomly assigned to undergo Billroth I or Roux‐en‐Y reconstruction after distal gastrectomy. We evaluated body weight change, nutritional status, late complications, quality of life (QOL) using the European Organization for Research and Treatment of Cancer Core QOL Questionnaire, and dysfunction using the Dysfunction After Upper Gastrointestinal Surgery for Cancer, 5 years after surgery. Results A total of 228 patients (Billroth I = 105; Roux‐en‐Y = 123) were eligible for efficacy analyses in this study. Body weight loss 5 years after surgery did not differ significantly between the Billroth I and Roux‐en‐Y groups (10.0% ± 7.9% and 9.6% ± 8.4%, respectively; P = .70). There were no significant differences in other aspects of nutritional status between the two groups. Reflux esophagitis occurred in 19.0% of the patients in the Billroth I group vs 4.9% in the Roux‐en‐Y group (P = .002). Regarding QOL, Billroth I was significantly inferior to Roux‐en‐Y on the diarrhea scale (Billroth I: 28.6, Roux‐en‐Y: 16.0; P = .047). Regarding dysfunction, no score differed significantly between the two groups. Conclusions Billroth I and Roux‐en‐Y reconstructions were generally equivalent regarding body weight change, nutritional status, and QOL 5 years after distal gastrectomy, although Roux‐en‐Y more effectively prevented reflux esophagitis and diarrhea.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 97%

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Comparison of 5‐year postoperative outcomes after Billroth I and Roux‐en‐Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi‐institutional randomized controlled trial

Kimura

Mikami

Yamasaki

et al. 2020

Annals of Gastroent Surgery

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“…Totally laparoscopic gastrectomy has shown distinct advantages comparing to laparoscopic-assisted gastrectomy [4][5][6] . In totally laparoscopic distal gastrectomy, digestive tract reconstruction has been a key and difficult part of the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Choosing the ideal method for digestive tract reconstruction in distal gastrectomy is still the focus of controversy. Various methods of anastomoses by stapler has been heavily reported in previous researches such as using linear staplers to perform Delta-shaped anastomosis, Billroth II anastomosis or Roux-en-Y anastomosis [2][3][4] . However, there are still many problems, such as high anastomotic tension, inaccurate tumor margins and large expenses.…”

Section: Introductionmentioning

confidence: 99%

Application of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy

Zhang¹,

Zhang²,

yuan³

et al. 2020

Preprint

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Background Retrospectively register the clinical data of distal gastric cancer patients who received surgical treatment, discuss the safety and feasibility of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy. Methods Review the clinical data of 41 patients with distal gastric cancer from the gastroenterology department of the Second Affiliated Hospital of Dalian Medical University, from September 2018 to August 2019, were accepted the totally laparoscopic distal gastrectomy. During the operation, the method of double needle-double layer continuous manual suture was used for Billroth I type anastomosis to complete digestive tract reconstruction. The peri-operative clinical information and postoperative follow-up information were collected for analysis, and the clinical application value was evaluated. Results General Information: Male (n = 27),Female(n = 14)༌Age(65.02 ± 9.94)years, BMI(23.52 ± 2.56)kg/m2; Tumor location: Antrum(32,78.0%), Angle (6,14.6%), Body (3,7.3%); Clinical stage: I (27,65.9%), II (7,17.1%), III (7,17.1%); Operative information: Operation time (154.51 ± 33.37)min, Anastomosis time (26.88 ± 5.11) min; Intraoperative bleeding (66.34 ± 48.81) ml; First postoperative ambulation (1.07 ± 0.26) d, First postoperative flatus(3.07 ± 1.08)d, First postoperative diet(3.41 ± 1.07)d༌Postoperative hospital stay(8.76 ± 6.64)d, Total hospitalization cost (70804.00 ± 14282.05)RMB yuan; Differentiation degree: High and high-moderate(3,7.32%), Moderate and poor-moderate (24,58.54%)༌Poor differentiation (14,34.15%); Dissected lymph node (32.76 ± 13.16), Positive lymph node (2.39 ± 4.06); Pathological stage: IA (20,48.78%), IB (3,7.32%), IIA (4,9.76%), IIB (5,12.20%), IIIA (1,2.44%), IIIB (3,7.32%), IIIC (5,12.20%); Complications(n = 4): Lung infection(1,2.44%)༌Anastomotic leakage (1,2.44%༉༌Gastroparesis (2,4.88%༉; Conclusion It is safe and feasible in clinical treatment to apply the method of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.

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Features of the complications for intracorporeal Billroth-I and Roux-en-Y reconstruction after laparoscopic distal gastrectomy for gastric cancer

Shoji

Kumagai

Ida

et al. 2021

Langenbecks Arch Surg

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Long-term functional outcomes of Roux-en-Y versus Billroth I reconstructions after laparoscopic distal gastrectomy for gastric cancer: a propensity-score matching analysis

Abstract: Roux-en-Y reconstruction was superior to Billroth I reconstruction in terms of frequency of occurrence of residual food, bile reflux, remnant gastritis, and reflux esophagitis in the long term. Differences between the two methods became more evident as the follow-up period lengthened.

Cited by 21 publications

References 22 publications

Comparison of 5‐year postoperative outcomes after Billroth I and Roux‐en‐Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi‐institutional randomized controlled trial

Comparison of 5‐year postoperative outcomes after Billroth I and Roux‐en‐Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi‐institutional randomized controlled trial

Application of double needle-double layer continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy

Features of the complications for intracorporeal Billroth-I and Roux-en-Y reconstruction after laparoscopic distal gastrectomy for gastric cancer

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