A comparison of postoperative quality of life and dysfunction after Billroth i and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi-institutional RCT

Shuji Takiguchi, Kazuyoshi Yamamoto, Motohiro Hirao, Hiroshi Imamura, Junya Fujita, Masahiko Yano, Kenji Kobayashi, Yutaka Kimura, Yukinori Kurokawa, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalReview articlepeer-review

60 Citations (Scopus)

Abstract

Background Both Billroth I (B-I) and Roux-en-Y (R-Y) reconstructions are commonly performed as standard procedures, but it has yet to be determined which reconstruction is better for patients. A randomized prospective phase II trial with body weight loss at 1 year after surgery as a primary endpoint was performed to address this issue. The current report delivers data on the quality of life and degree of postoperative dysfunction, which were the secondary endpoints of this study. Methods Gastric cancer patients who underwent distal gastrectomy were intraoperatively randomized to B-I or R-Y. Postsurgical QOL was evaluated using the EORTC QLQ-C30 and DAUGS 20. Results Between August 2005 and December 2008, 332 patients were enrolled in a randomized trial comparing B-I versus R-Y. A mail survey questionnaire sent to 327 patients was completed by 268 (86.2%) of them. EORTC QLQ-C30 scores were as follows: global health status was similar in each group (B-I 73.5 ± 18.8, R-Y 73.2 ± 20.2, p = 0.87). Scores of five functional scales were also similar. Only the dyspnea symptom scale showed superior results for R-Y than for B-I (B-I 13.6 ± 17.9, R-Y 8.6 ± 16.3, p = 0.02). With respect to DAUGS 20, the total score did not differ significantly between the R-Y and B-I groups (24.8 vs. 23.6, p = 0.41). Only reflux symptoms were significantly worse for B-I than for R-Y (0.7 ± 0.6 vs. 0.5 ± 0.6, p = 0.01). Conclusions The B-I and R-Y techniques were generally equivalent in terms of postoperative QOL and dysfunction. Both procedures seem acceptable as standard reconstructions after distal gastrectomy with regard to postoperative QOL and dysfunction.

Original languageEnglish
Pages (from-to)198-205
Number of pages8
JournalGastric Cancer
Volume15
Issue number2
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

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