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01-05-2013 | Gastrointestinal Oncology

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

Authors: Motohiro Hirao, MD, PhD, Shuji Takiguchi, MD, PhD, Hiroshi Imamura, MD, PhD, Kazuyoshi Yamamoto, MD, PhD, Yukinori Kurokawa, MD, PhD, Junya Fujita, MD, PhD, Kenji Kobayashi, MD, PhD, Yutaka Kimura, MD, PhD, Masaki Mori, MD, PhD, Yuichiro Doki, MD, PhD, Osaka University Clinical Research Group for Gastroenterological Study

Published in: Annals of Surgical Oncology | Issue 5/2013

Abstract

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.

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Title: 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
Authors: Motohiro Hirao, MD, PhD
Shuji Takiguchi, MD, PhD
Hiroshi Imamura, MD, PhD
Kazuyoshi Yamamoto, MD, PhD
Yukinori Kurokawa, MD, PhD
Junya Fujita, MD, PhD
Kenji Kobayashi, MD, PhD
Yutaka Kimura, MD, PhD
Masaki Mori, MD, PhD
Yuichiro Doki, MD, PhD
Osaka University Clinical Research Group for Gastroenterological Study
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2704-9

ACC 2024 Congress

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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