Comparison of Billroth i and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: One-year postoperative effects assessed by a multi-institutional RCT

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

研究成果: ジャーナルへの寄稿学術誌査読

75 被引用数 (Scopus)

抄録

Purpose: This randomized, controlled trial evaluated the clinical efficacy of Billroth I (BI) and Roux-en-Y (RY) reconstruction at 1 year after distal gastrectomy for gastric cancer. Methods: The primary end point was the amount of body weight lost at 1 postoperative year, and secondary end points included other items related to nutritional status such as serum albumin and lymphocyte count, as well as endoscopic examination findings of the remnant stomach and esophagus. Of the 332 patients enrolled, 163 were assigned to the BI group and 169 were randomized to the RY group. Results: The loss in body weight 1 year after surgery did not differ significantly between the BI and RY groups (9.1 % and 9.7 %, respectively, p = 0.39). There were no significant differences in other aspects of nutritional status between the 2 groups. Endoscopic examination 1 year after gastrectomy showed reflux esophagitis in 26 patients (17 %) in the BI group versus 10 patients (6 %) in the RY group (p = 0.0037), while remnant gastritis was observed in 71 patients (46 %) in the BI group versus 44 patients (28 %) in the RY group (p = 0.0013); differences were significant for both conditions. Multivariable analysis showed that the only reconstruction was the independently associated factor with the incidence of reflux esophagitis. Conclusions: RY reconstruction was not superior to BI in terms of body weight change or other aspects of nutritional status at 1 year after surgery, although RY more effectively prevented reflux esophagitis and remnant gastritis after distal gastrectomy.

本文言語英語
ページ(範囲)1591-1597
ページ数7
ジャーナルAnnals of Surgical Oncology
20
5
DOI
出版ステータス出版済み - 5月 2013
外部発表はい

!!!All Science Journal Classification (ASJC) codes

  • 外科
  • 腫瘍学

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