Yutaka Kimura1, Jota Mikami2, Makoto Yamasaki3, Motohiro Hirao4, Hiroshi Imamura5, Junya Fujita6, Atsushi Takeno7, Jin Matsuyama8, Kentaro Kishi9, Takafumi Hirao10, Hiroki Fukunaga11, Koichi Demura12, Yukinori Kurokawa3, Shuji Takiguchi13, Hidetoshi Eguchi3, Yuichiro Doki3. 1. Department of Surgery Faculty of Medicine Kindai University Osaka-Sayama Japan. 2. Department of Surgery Hyogo Prefectural Nishinomiya Hospital Nishinomiya Japan. 3. Department of Gastroenterological Surgery Osaka University Graduate School of Medicine Suita Japan. 4. Department of Surgery National Hospital Organization Osaka National Hospital Osaka Japan. 5. Department of Surgery Toyonaka Municipal Hospital Toyonaka Japan. 6. Department of Surgery Sakai City Medical Center Sakai Japan. 7. Department of Surgery Kansai Rosai Hospital Amagasaki Japan. 8. Department of Gastroenterological Surgery Higashiosaka City Medical Center Higashiosaka Japan. 9. Department of Surgery Osaka Police Hospital Osaka Japan. 10. Department of Surgery Minoh City Hospital Minoh Japan. 11. Department of Surgery Itami City Hospital Itami Japan. 12. Department of Surgery JCHO Osaka Hospital Osaka Japan. 13. Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan.
Abstract
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.
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.
Authors: K Kobayashi; F Takeda; S Teramukai; I Gotoh; H Sakai; S Yoneda; Y Noguchi; H Ogasawara; K Yoshida Journal: Eur J Cancer Date: 1998-05 Impact factor: 9.162
Authors: N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes Journal: J Natl Cancer Inst Date: 1993-03-03 Impact factor: 13.506
Authors: Jennifer Straatman; Nicole van der Wielen; Pieter J Joosten; Caroline B Terwee; Miguel A Cuesta; Elise P Jansma; Donald L van der Peet Journal: Surg Endosc Date: 2015-08-27 Impact factor: 4.584