Linhua Jiang1, Jiawen Zhang1, Xinguo Zhu2. 1. Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China. 2. Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China. zhuxinguo2020@163.com.
Abstract
BACKGROUND: Gastric cancer is a major public health problem around the globe. With the standardization of tumor treatment, surgery continues to be the most important treatment method for gastric cancer. However, changes in body composition and nutrition index parameters in patients with Billroth II and Roux-en-Y anastomosis following totally laparoscopic distal gastrectomy (TLDG) remain unclear. METHODS: This was a single-center retrospective study. A total of 369 patients who underwent TLDG at the First Affiliated Hospital of Soochow University (Suzhou, China) between January 2016 and February 2019 were included and assigned to the Billroth II group or Roux-en-Y group according to the anastomosis method. After propensity score matching, body composition and relevant clinical data were compared between the two groups. RESULTS: The operation time for the Billroth II group was significantly shorter than for the Roux-en-Y group (174.12 ± 39.33 min vs. 229.19 ± 28.12 min, P < 0.001). In addition, the Billroth II group showed lower skeletal muscle loss. Specifically, the Billroth II group showed a - 4.77 ± 4.88% change in the skeletal muscle index (SMI), whereas the Roux-en-Y group showed a - 11.89 ± 8.68% change (P = 0.001). The Billroth II group also showed a smaller decrease in BMI than the Roux-en-Y group (- 6.67 ± 7.76% vs. - 13.12 ± 10.79%, P = 0.018). CONCLUSIONS: These results suggest that Billroth II anastomosis after TLDG has advantages over Roux-en-Y for maintaining patient body composition, especially in terms of SMI, and may serve as a useful reference when choosing an anastomosis method.
BACKGROUND: Gastric cancer is a major public health problem around the globe. With the standardization of tumor treatment, surgery continues to be the most important treatment method for gastric cancer. However, changes in body composition and nutrition index parameters in patients with Billroth II and Roux-en-Y anastomosis following totally laparoscopic distal gastrectomy (TLDG) remain unclear. METHODS: This was a single-center retrospective study. A total of 369 patients who underwent TLDG at the First Affiliated Hospital of Soochow University (Suzhou, China) between January 2016 and February 2019 were included and assigned to the Billroth II group or Roux-en-Y group according to the anastomosis method. After propensity score matching, body composition and relevant clinical data were compared between the two groups. RESULTS: The operation time for the Billroth II group was significantly shorter than for the Roux-en-Y group (174.12 ± 39.33 min vs. 229.19 ± 28.12 min, P < 0.001). In addition, the Billroth II group showed lower skeletal muscle loss. Specifically, the Billroth II group showed a - 4.77 ± 4.88% change in the skeletal muscle index (SMI), whereas the Roux-en-Y group showed a - 11.89 ± 8.68% change (P = 0.001). The Billroth II group also showed a smaller decrease in BMI than the Roux-en-Y group (- 6.67 ± 7.76% vs. - 13.12 ± 10.79%, P = 0.018). CONCLUSIONS: These results suggest that Billroth II anastomosis after TLDG has advantages over Roux-en-Y for maintaining patient body composition, especially in terms of SMI, and may serve as a useful reference when choosing an anastomosis method.
Authors: Lindsey A Torre; Freddie Bray; Rebecca L Siegel; Jacques Ferlay; Joannie Lortet-Tieulent; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2015-02-04 Impact factor: 508.702
Authors: Thuy B Tran; David J Worhunsky; Malcolm H Squires; Linda X Jin; Gaya Spolverato; Konstantinos I Votanopoulos; Clifford S Cho; Sharon M Weber; Carl Schmidt; Edward A Levine; Mark Bloomston; Ryan C Fields; Timothy M Pawlik; Shishir K Maithel; Jeffrey A Norton; George A Poultsides Journal: Gastric Cancer Date: 2015-09-23 Impact factor: 7.370