Billroth 1 versus Roux-en-Y reconstructions: a quality-of-life survey at 5 years

Nunobe, Souya; Okaro, Abuchi; Sasako, Mitsuru; Saka, Makoto; Fukagawa, Takeo; Katai, Hitoshi; Sano, Takeshi

doi:10.1007/s10147-007-0706-6

Cited by 98 publications

(93 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients infrequently experienced heartburn (6.7%) and only two patients had endoscopic evidence of reflux esophagitis. On the other hand, bile reflux into the remnant stomach was observed endoscopically in 73.5% of our patients, a rate higher than what has previously been reported [8,10,11]. However, the incidence of remnant gastritis was low and severe symptoms were rarely observed.…”

Section: Discussioncontrasting

confidence: 67%

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

et al. 2011

View full text Add to dashboard Cite

Background We developed a new method of intracorporeal gastroduodenostomy, the delta-shaped anastomosis, in which only endoscopic linear staplers are used. In this report, we present the short-and long-term outcomes of our initial experience with this procedure. Methods We retrospectively analyzed 100 consecutive gastric cancer patients who underwent the delta-shaped anastomosis procedure from May 2001 to November 2006. All of them underwent a laparoscopic distal gastrectomy with regional lymph node dissection. Quality of life was assessed with a questionnaire 6 months or more postoperatively, and the gastric remnant was evaluated by endoscopy one year following the surgery. Results Eight surgeons successfully performed the deltashaped anastomosis without any conversion to laparotomy. The learning curve for all surgeons was steep and the mean time for the anastomosis was 13 min. Only one patient developed an anastomotic leak, and the leak was minor. Sixty-five patients tolerated a 1500 kcal/day soft diet at the time of discharge. The mean follow-up period was 54.9 months. Only one patient reported symptoms indicative of dumping. Two patients were diagnosed with reflux esophagitis, and approximately 70% had evidence of bile reflux, but severe gastritis of the remnant stomach on endoscopy was uncommon. Conclusions The wide lumen of the delta-shaped anastomosis led to early, adequate postoperative oral intake without a significant incidence of dumping syndrome. The delta-shaped anastomosis is safe and simple and provides satisfactory postoperative results.

show abstract

Section: Discussioncontrasting

confidence: 67%

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Miyagaki et al [12] reported the reduction (13.5 %) after distal gastrectomy in their study was larger than in other studies (range, 9.1-10.5 %). In our study, the reduction after distal gastrectomy was 11.4 % on average (data not shown), which was also slightly larger than in other studies [13,14]. Weight loss is considered a risk factor for internal hernia in RYGBP [15,16].…”

Section: Resultscontrasting

confidence: 45%

Petersen’s hernia after laparoscopic distal gastrectomy with Roux-en-Y reconstruction for gastric cancer

et al. 2013

View full text Add to dashboard Cite

Background To decrease the incidence of internal hernia after laparoscopic Roux-en-Y gastric bypass, recent recommendations indicated closure of mesenteric defects and Petersen's defect. Laparoscopic distal gastrectomy for gastric cancer is used increasingly, so the incidence of Petersen's hernia can also increase, but the trend has not been studied. Methods This study retrospectively reviewed 358 consecutive patients who underwent laparoscopic distal gastrectomy for gastric cancer at one institution, with antecolic Roux-en-Y (RY) reconstruction. Results Petersen's hernia occurred in 6 (2.2 %) of 268 patients whose Petersen's defect was not closed by a mean of 351 days after surgery. All the patients underwent reoperation with reduction and repair of the hernia except the first case. In 90 subsequent cases, with closure of the Petersen's defect, internal hernias did not occur (0/90 cases; p = 0.06). Focusing on the totally laparoscopic procedure, Petersen's hernia occurred in 2 (5.1 %) of 39 patients, whereas in 81 subsequent cases, with closure of Petersen's defect, internal hernias did not occur (0/81 cases; p = 0.03). Conclusions Based on the recent recommendations for bariatric surgery, closure of this potential hernia defect is necessary after laparoscopic distal gastrectomy with R-Y reconstruction for gastric cancer.

show abstract

“…Increased F-18 FDG uptake in inflammatory and infectious lesions is well established [23,27,28]. It is well documented that patients with a gastroduodenostomy have reflux of duodenal contents into the remnant stomach due to the absence of the pyloric sphincter, leading to gastritis [14,17]. Therefore, several factors such as normal physiologic uptake, inflammation and fibrosis after surgery could contribute to the persistent increase in F-18 FDG uptake at the anastomotic site.…”

Section: Discussionmentioning

confidence: 99%

“…Its utility has been well demonstrated in many studies, especially in cases of intraluminal recurrence [13][14][15][16][17]. However, there are some limitations to endoscopy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Choi

Zeon

Kim

et al. 2011

Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose The aim of this study was to characterize the patterns of fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography/computed tomography (FDG PET/CT) at the anastomotic site of gastroduodenostomy after distal subtotal gastrectomy in patients with gastric cancer. Methods From May 2007 to May 2010, two or more follow-up measurements using FDG PET/CT scans were done for 19 patients (11 men, 8 women; mean age, 62.0± 10.3 years) who underwent distal subtotal gastrectomy with gastroduodenostomy between February 2006 and March 2008 for detecting gastric cancer recurrence at our medical center. The FDG PET/CT images were retrospectively reviewed. Patients with local recurrence, regional nodal metastasis or distant metastasis on follow-up studies were excluded. CT and endoscopy were done within 1 month before or after the FDG PET/CT scan. Eight patients had two follow-ups of FDG PET/CT, and 11 patients had three follow-ups. The mean interval between surgery and the first follow-up FDG PET/CT was 12.9±0.8 months (n=19); between the first and second it was 12.3±1.0 months (n= 19); between the second and third it was 11.6±0.7 months (n=11). The F-18 FDG uptakes at the anastomotic site and fundus in the remnant stomach were measured by maximum standardized uptake value (SUVmax) using a region of interest technique.Results The SUVmax at the anastomotic site was significantly higher than that of the fundus on all series of first, second and third follow-up studies (3.3±1.1 vs. 2.1±0.7, p<0.001: 3.1±0.9 vs. 2.2±0.7, p=0.001: 3.0±0.6 vs. 2.1±0.7, p=0.006, respectively). The SUVmax for the anastomotic site and fundus, and SUVmax ratio for the anastomotic site over the fundus were not significantly different throughout the series. Conclusion The SUVmax at the anastomotic site is significantly higher than that of the fundus and does not decrease significantly over time. Therefore, the local recurrence of gastric cancer after surgery could not be definitely differentiated from physiologic uptake or postoperative inflammatory change.

show abstract

Billroth 1 versus Roux-en-Y reconstructions: a quality-of-life survey at 5 years

Cited by 98 publications

References 30 publications

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy

Petersen’s hernia after laparoscopic distal gastrectomy with Roux-en-Y reconstruction for gastric cancer

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Contact Info

Product

Resources

About