Comparison between Roux-en-Y gastrojejunostomy and Billroth-II with Braun anastomosis following partial gastrectomy: A randomized controlled trial

Shishegar, Azita; Vahedi, Matin; Kamani, Fereshteh; Kazerouni, Mehrdad Fathi; Pasha, Morteza Aghajanpour; Fathi, Farhad

doi:10.1016/j.amsu.2022.103544

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…R-Y mesentery separation and jejunum dissection did not increase the risk of bleeding but prolonged the operative time. In addition, Yalikun A reported no signi cant difference in early postoperative complications between the R-Y (14.7%) and BII + B (7.5%) procedures, which is similar to Shishegar A's ndings [28,29]. In the present study, no signi cant differences were observed in the incidence of early complications (R-Y: 8.8% vs. BII + B: 10.6%) or late complications (R-Y: 10.5% vs. BII + B: 12.8%) between the two groups.…”

Section: Discussionsupporting

confidence: 72%

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Chen

Huang

Wang

et al. 2023

Preprint

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BACKGROUND: The controversy surrounding Roux-en-Y and Billroth II with Braun anastomosis as an anti-bile reflux procedure after distal gastrectomy has persisted. Recent studies have demonstrated their efficacy, but the long-term outcomes and postoperative quality of life (QoL) among patients have yet to be evaluated. Therefore, we compared the short-term and long-term outcomes of the two procedures as well as QoL.METHODS The clinical data of 151 patients who underwent total laparoscopic distal gastrectomy at the Second Hospital of Fujian Medical University from January 2016 to December 2019 were retrospectively analyzed. Of these, 57 cases with Roux-en-Y anastomosis (R-Y group) and 94 cases with Billroth II with Braun anastomosis were included (BII + B group). Operative and postoperative conditions, early and late complications, endoscopic outcomes at year 1 and year 3 after surgery, nutritional indicators, and quality of life scores at year 3 postoperatively were compared between the two groups.RESULTS The R-Y group recorded a significantly longer operative time (194.65 ± 21.52 min vs. 183.88 ± 18.02 min) and anastomotic time (36.96 ± 2.43 min vs. 27.97 ± 3.74 min) compared to the BII + B group (P < 0.05). However, no other significant differences were observed in terms of blood loss or postoperative conditions (P > 0.05). Both groups showed comparable rates of early and late complications. Endoscopic findings indicated similar food residuals at years 1 and 3 postsurgery for both groups. The R-Y group had a lower occurrence of residual gastritis and bile reflux at year 1 and year 3 after surgery, with a statistically significant difference (P < 0.001). Reflux esophagitis was not significantly different between the R-Y and BII + B groups in year 1 after surgery, but the R-Y group had a lower incidence than the BII + B group in year 3 after surgery (P = 0.023). Nutritional outcomes at 3 years after surgery did not differ significantly between the two groups (P > 0.05). Quality of life scores measured by the QLQ-C30 scale were not significantly different between the two groups. However, on the QLQ-STO22 scale, the reflux score was significantly lower in the R-Y group than in the BII + B group (0 [0, 0] vs. 5.56 [0, 11.11]) (P = 0.003). The rest of the scores were not significantly different (P > 0.05).CONCLUSION Both R-Y and B II + B are equally safe and efficient for TLDG. Nevertheless, R-Y reduces the incidence of residual gastritis, bile reflux, and reflux esophagitis, as well as postoperative reflux symptoms, and provides a better quality of life for patients.

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Section: Discussionsupporting

confidence: 72%

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Chen

Huang

Wang

et al. 2023

Preprint

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Section: Discussionmentioning

confidence: 99%

“…Gastric malignancies account for 930000 over 1000000 new cases and 700000 deaths annually[ 15 , 29 ]. Gastric cancer is considered the third deadliest, while being the fifth most commonly diagnosed[ 15 ]. Considering the progress in earlier diagnosis a more preservative attitude towards distal gastric cancer resection has been recently adopted, since there is no difference regarding long term survival rates between distal and total gastrectomy[ 12 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gastric cancer is considered the third deadliest, while being the fifth most commonly diagnosed[ 15 ]. Considering the progress in earlier diagnosis a more preservative attitude towards distal gastric cancer resection has been recently adopted, since there is no difference regarding long term survival rates between distal and total gastrectomy[ 12 , 15 ]. The extent of the portion of the stomach removed, given adequate oncologic margins (≥ 3 cm for T2 tumors or types 1 and 2 and ≥ 5 cm for types 3 and 4) does not constitute a prognostic factor, unlike perigastric lymph node clearance.…”

Section: Discussionmentioning

confidence: 99%

“…Distal gastrectomy[ 12 - 14 ] remains the operation of choice for distal-third gastric cancer, as followed by lower mortality and morbidity rates, higher quality of life and no significant difference as far as long-term survival rates are concerned, compared to total gastrectomy, with the efforts now leaning on maintaining the continuity of the Gastrointestinal tract[ 15 , 16 ]. Moreover, the surgeon performing a distal gastrectomy, has a variety of reconstruction techniques, Billroth-I, Billroth-II, and Roux-en-Y, each with its respective advantages and disadvantages, at his disposal[ 5 , 10 - 12 , 16 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients

Christodoulidis,

Kouliou,

Koumarelas

et al. 2024

World J Methodol

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BACKGROUND The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality. AIM To compare Billroth II vs Billroth II and Braun following distal gastrectomy, regarding their postoperative course. METHODS Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed. RESULTS There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL vs 1102.78 mL) and it was statistically significant (P < 0.0001). Mean daily postoperative NGT output was also statistically significantly lower in Braun group. According to the postoperative follow up 40 patient experienced bile reflux and alkaline gastritis from the Billroth II group, while 9 patients who underwent Billroth II and Braun anastomosis were presented with the same conditions (P < 0.05). CONCLUSION There was evidence of superiority of Billroth II and Braun vs typical Billroth II in terms of bile reflux, alkaline gastritis and NGT output.

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Diagnosis to dissection: AI’s role in early detection and surgical intervention for gastric cancer

Pattilachan,

Christodoulou,

Ross

2024

J Robotic Surg

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Comparison between Roux-en-Y gastrojejunostomy and Billroth-II with Braun anastomosis following partial gastrectomy: A randomized controlled trial

Cited by 5 publications

References 19 publications

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Short-Term and Long-Term Outcomes and Quality of Life Comparison of Total Laparoscopic Distal Gastrectomy Reconstruction: Roux-en-Y versus Billroth II+Braun

Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients

Diagnosis to dissection: AI’s role in early detection and surgical intervention for gastric cancer

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