Impact of reconstruction method on visceral fat change after distal gastrectomy: Results from a randomized controlled trial comparing Billroth i reconstruction and Roux-en-Y reconstruction

Koji Tanaka, Shuji Takiguchi, Isao Miyashiro, Motohiro Hirao, Kazuyoshi Yamamoto, Hiroshi Imamura, Masahiko Yano, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Visceral fat is one of the causes of metabolic syndrome. Among the various types of bariatric surgery, duodenal-jejunal bypass is one of the most common procedures. However, the effect of duodenal bypass on fat changes is not completely understood. We examined the effect of duodenal bypass on visceral fat changes by comparing Billroth I (BI) and roux-en Y (RY) reconstruction in distal gastrectomy. Methods This retrospective study used data from 221 patients registered for a prospective randomized trial that compared BI to RY in distal gastrectomy with lymphadenectomy to treat gastric cancer. With a software package, we first quantified the visceral fat area (VFA) on cross-sectional computed tomography scans obtained at the level of the umbilicus before and 1 year after surgery, and then determined the impact of duodenal bypass on visceral fat changes. Results Clinicopathological background data did not differ between BI and RY. Rates of BMI reduction for BI and RY also did not differ. The VFA reduction rate for RY (47.2 ± 25.5%) was greater than for BI (36.8 ± 34.2%, P =.0104). Adjuvant chemotherapy (chemotherapy versus no chemotherapy, P =.0136), type of reconstruction (BI versus RY, P <.0001), and pathologic stage (p stage I versus p stage II-IV, P =.0468) correlated significantly with postoperative visceral fat loss. Multivariate logistic regression analysis identified reconstruction (BI versus RY, P =.0078) as a significant determinant of visceral fat loss. Conclusion Visceral fat loss after distal gastrectomy was greater for RY than for BI, and duodenal bypass may be associated with reduction of visceral fat.

Original languageEnglish
Pages (from-to)424-431
Number of pages8
JournalSurgery (United States)
Volume155
Issue number3
DOIs
Publication statusPublished - Mar 1 2014
Externally publishedYes

Fingerprint

Intra-Abdominal Fat
Gastroenterostomy
Gastrectomy
Randomized Controlled Trials
Umbilicus
Drug Therapy
Bariatric Surgery
Adjuvant Chemotherapy
Lymph Node Excision
Stomach Neoplasms
Software
Retrospective Studies
Logistic Models
Fats
Tomography
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Impact of reconstruction method on visceral fat change after distal gastrectomy : Results from a randomized controlled trial comparing Billroth i reconstruction and Roux-en-Y reconstruction. / Tanaka, Koji; Takiguchi, Shuji; Miyashiro, Isao; Hirao, Motohiro; Yamamoto, Kazuyoshi; Imamura, Hiroshi; Yano, Masahiko; Mori, Masaki; Doki, Yuichiro.

In: Surgery (United States), Vol. 155, No. 3, 01.03.2014, p. 424-431.

Research output: Contribution to journalArticle

Tanaka, Koji ; Takiguchi, Shuji ; Miyashiro, Isao ; Hirao, Motohiro ; Yamamoto, Kazuyoshi ; Imamura, Hiroshi ; Yano, Masahiko ; Mori, Masaki ; Doki, Yuichiro. / Impact of reconstruction method on visceral fat change after distal gastrectomy : Results from a randomized controlled trial comparing Billroth i reconstruction and Roux-en-Y reconstruction. In: Surgery (United States). 2014 ; Vol. 155, No. 3. pp. 424-431.
@article{0b11b63983a84a128c87b54390fa38ec,
title = "Impact of reconstruction method on visceral fat change after distal gastrectomy: Results from a randomized controlled trial comparing Billroth i reconstruction and Roux-en-Y reconstruction",
abstract = "Background Visceral fat is one of the causes of metabolic syndrome. Among the various types of bariatric surgery, duodenal-jejunal bypass is one of the most common procedures. However, the effect of duodenal bypass on fat changes is not completely understood. We examined the effect of duodenal bypass on visceral fat changes by comparing Billroth I (BI) and roux-en Y (RY) reconstruction in distal gastrectomy. Methods This retrospective study used data from 221 patients registered for a prospective randomized trial that compared BI to RY in distal gastrectomy with lymphadenectomy to treat gastric cancer. With a software package, we first quantified the visceral fat area (VFA) on cross-sectional computed tomography scans obtained at the level of the umbilicus before and 1 year after surgery, and then determined the impact of duodenal bypass on visceral fat changes. Results Clinicopathological background data did not differ between BI and RY. Rates of BMI reduction for BI and RY also did not differ. The VFA reduction rate for RY (47.2 ± 25.5{\%}) was greater than for BI (36.8 ± 34.2{\%}, P =.0104). Adjuvant chemotherapy (chemotherapy versus no chemotherapy, P =.0136), type of reconstruction (BI versus RY, P <.0001), and pathologic stage (p stage I versus p stage II-IV, P =.0468) correlated significantly with postoperative visceral fat loss. Multivariate logistic regression analysis identified reconstruction (BI versus RY, P =.0078) as a significant determinant of visceral fat loss. Conclusion Visceral fat loss after distal gastrectomy was greater for RY than for BI, and duodenal bypass may be associated with reduction of visceral fat.",
author = "Koji Tanaka and Shuji Takiguchi and Isao Miyashiro and Motohiro Hirao and Kazuyoshi Yamamoto and Hiroshi Imamura and Masahiko Yano and Masaki Mori and Yuichiro Doki",
year = "2014",
month = "3",
day = "1",
doi = "10.1016/j.surg.2013.08.008",
language = "English",
volume = "155",
pages = "424--431",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Impact of reconstruction method on visceral fat change after distal gastrectomy

T2 - Results from a randomized controlled trial comparing Billroth i reconstruction and Roux-en-Y reconstruction

AU - Tanaka, Koji

AU - Takiguchi, Shuji

AU - Miyashiro, Isao

AU - Hirao, Motohiro

AU - Yamamoto, Kazuyoshi

AU - Imamura, Hiroshi

AU - Yano, Masahiko

AU - Mori, Masaki

AU - Doki, Yuichiro

PY - 2014/3/1

Y1 - 2014/3/1

N2 - Background Visceral fat is one of the causes of metabolic syndrome. Among the various types of bariatric surgery, duodenal-jejunal bypass is one of the most common procedures. However, the effect of duodenal bypass on fat changes is not completely understood. We examined the effect of duodenal bypass on visceral fat changes by comparing Billroth I (BI) and roux-en Y (RY) reconstruction in distal gastrectomy. Methods This retrospective study used data from 221 patients registered for a prospective randomized trial that compared BI to RY in distal gastrectomy with lymphadenectomy to treat gastric cancer. With a software package, we first quantified the visceral fat area (VFA) on cross-sectional computed tomography scans obtained at the level of the umbilicus before and 1 year after surgery, and then determined the impact of duodenal bypass on visceral fat changes. Results Clinicopathological background data did not differ between BI and RY. Rates of BMI reduction for BI and RY also did not differ. The VFA reduction rate for RY (47.2 ± 25.5%) was greater than for BI (36.8 ± 34.2%, P =.0104). Adjuvant chemotherapy (chemotherapy versus no chemotherapy, P =.0136), type of reconstruction (BI versus RY, P <.0001), and pathologic stage (p stage I versus p stage II-IV, P =.0468) correlated significantly with postoperative visceral fat loss. Multivariate logistic regression analysis identified reconstruction (BI versus RY, P =.0078) as a significant determinant of visceral fat loss. Conclusion Visceral fat loss after distal gastrectomy was greater for RY than for BI, and duodenal bypass may be associated with reduction of visceral fat.

AB - Background Visceral fat is one of the causes of metabolic syndrome. Among the various types of bariatric surgery, duodenal-jejunal bypass is one of the most common procedures. However, the effect of duodenal bypass on fat changes is not completely understood. We examined the effect of duodenal bypass on visceral fat changes by comparing Billroth I (BI) and roux-en Y (RY) reconstruction in distal gastrectomy. Methods This retrospective study used data from 221 patients registered for a prospective randomized trial that compared BI to RY in distal gastrectomy with lymphadenectomy to treat gastric cancer. With a software package, we first quantified the visceral fat area (VFA) on cross-sectional computed tomography scans obtained at the level of the umbilicus before and 1 year after surgery, and then determined the impact of duodenal bypass on visceral fat changes. Results Clinicopathological background data did not differ between BI and RY. Rates of BMI reduction for BI and RY also did not differ. The VFA reduction rate for RY (47.2 ± 25.5%) was greater than for BI (36.8 ± 34.2%, P =.0104). Adjuvant chemotherapy (chemotherapy versus no chemotherapy, P =.0136), type of reconstruction (BI versus RY, P <.0001), and pathologic stage (p stage I versus p stage II-IV, P =.0468) correlated significantly with postoperative visceral fat loss. Multivariate logistic regression analysis identified reconstruction (BI versus RY, P =.0078) as a significant determinant of visceral fat loss. Conclusion Visceral fat loss after distal gastrectomy was greater for RY than for BI, and duodenal bypass may be associated with reduction of visceral fat.

UR - http://www.scopus.com/inward/record.url?scp=84894028225&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894028225&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2013.08.008

DO - 10.1016/j.surg.2013.08.008

M3 - Article

C2 - 24287145

AN - SCOPUS:84894028225

VL - 155

SP - 424

EP - 431

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 3

ER -