Randomized clinical trial comparing long-term quality of life for Billroth I<i>versus</i>Roux-en-Y reconstruction after distal gastrectomy for gastric cancer

Nakamura, Masaki; Nakamori, Mikihito; Ojima, Toshiyasu; Itō, Makoto; Horiuchi, Tetsuya; Kobayashi, Yuki; Yamade, Naohisa; Shimada, Kazuaki; Oka, Masaaki; Yamaue, Hiroki

doi:10.1002/bjs.10060

Cited by 66 publications

(58 citation statements)

References 41 publications

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“…Nakamura et al . also found that symptom scales at 12 months were not significantly different, but were significantly better in the B-I group at 36 months after gastrectomy 34 . These were different from the previous studies indicating that the postoperative 6 months was a cut-point of QoL 35 , 36 .…”

Section: Discussionmentioning

confidence: 80%

Comparison of quality of life between Billroth-І and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A randomized controlled trial

Yang

Zhang

Liu

et al. 2017

Sci Rep

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Studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) anastomosis are still lacking and inconsistent. The aim of this trial was to compare the quality of life (QoL) of B-I with R-Y reconstruction after curative distal gastrectomy for gastric cancer. A total of 140 patients were randomly assigned to the B-I group (N = 70) and R-Y group (N = 70) with the comparable baseline characteristics. The overall postoperative morbidity rates were 18.6% and 25.7% in the B-I group and R-Y group without significant difference. More estimated blood loss and longer surgical duration were found in the R-Y group. At the postoperative 1 year time point, the B-I group had a higher score in pain, but lower score in global health. However, the R-Y anastomosis was associated with lower incidence of reflux symptoms at postoperative 6 months (P = 0.002) and postoperative 9 months (P = 0.007). The multivariable analyses of variance did not show any interactions between the time trend and grouping. For the results of endoscopic examination, the degree and extent of remnant gastritis were milder significantly in the R-Y group. The stronger anti-reflux capability of R-Y anastomosis contributes to the higher QoL by reducing the reflux related gastritis and pain symptoms, and promotes a better global health.

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Section: Discussionmentioning

confidence: 80%

Comparison of quality of life between Billroth-І and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A randomized controlled trial

Yang

Zhang

Liu

et al. 2017

Sci Rep

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“… 20 21 Although this surgery takes more time to perform, it is expected to become more commonly performed based on its clear advantages; however, debate remains, and further studies are required. 22 …”

Section: Discussionmentioning

confidence: 99%

Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014

Eom¹,

안혜성²,

이인섭³

et al. 2016

J Gastric Cancer

160

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PurposeThe Korean Gastric Cancer Association (KGCA) has conducted nationwide surveys every 5 years, targeting patients who received surgical treatment for gastric cancer. We report the results of the 2014 nationwide survey and compare them to those of the 1995, 1999, 2004, and 2009 surveys.Materials and MethodsFrom March 2015 to January 2016, a standardized case report form was sent to every member of the KGCA via e-mail. The survey consisted of 29 questions, regarding patient demographics as well as tumor-, and surgery-related factors. The completed data forms were analyzed by the KGCA information committee.ResultsData on 15,613 patients were collected from 69 institutions. The mean age was 60.9±12.1 years, and the proportion of patients more than 70 years of age increased from 9.1% in 1995 to 25.3% in 2014. Proximal cancer incidence steadily increased from 11.2% in 1995 to 16.0% in 2014. Early gastric cancer incidence consistently increased and accounted for 61.0% of all cases in 2014. The surgical approach was diversified in 2014, and 7,818 cases (50.1%) were treated with a minimally invasive approach. The most common anastomosis was Billroth I (50.2%) after distal gastrectomy, and the proportion of Roux-en-Y anastomoses performed increased to 8.6%.ConclusionsThe results of this survey are expected to be important data for future studies and to be useful for generating a national cancer control program.

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“…17 Cai et al reviewed the reconstruction method after distal gastrectomy, and LA classification was used in 3 of 8 papers, and 4 of 8 papers reported results according to RGB classification. [23][24][25][26][27][28] Again, only one in eight papers reported results for all three: LA classification, RGB classification, and ref lux symptom. 26 The limitations of this study are that it is a retrospective observational study, that only three surgeons in a single center participated, and there was a small sample size as an observational study.…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25][26][27][28] Again, only one in eight papers reported results for all three: LA classification, RGB classification, and ref lux symptom. 26 The limitations of this study are that it is a retrospective observational study, that only three surgeons in a single center participated, and there was a small sample size as an observational study. Additionally, we did not find strong evidence to prove safety and effectiveness of the new surgical technique.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy

Kim

Yehuda

Kim

et al. 2020

J Minim Invasive Surg

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Purpose Various reconstruction methods have been proposed to reduce reflux after proximal gastrectomy, and we report here a double shouldering technique. The purpose of this study is to compare the novel double shouldering technique with conventional esophagogastrostomy in terms of short term and 3-year clinical outcome. Methods A retrospective observational case control study was performed on 63 patients for cT1N0 upper third gastric cancer who underwent proximal gastrectomy from January 2012 to November 2016 at the National Cancer Center, Korea. There were 26 patients with conventional esophagogastrostomy, and 37 patients with novel double shouldering technique. The primary outcome was endoscopic reflux esophagitis findings one and three year after surgery according to Los Angeles classification. Secondary outcomes were short term surgical outcome and reflux symptom. Results There was no significant difference in reflux esophagitis on endoscopic findings at 1 and 3 years after surgery between the two group. The double shouldering (DS) technique group showed significantly better postoperative outcomes with bile reflux at one and three years via endoscopic findings versus conventional esophagogastrostomy (CEG). Operative time and hospital stay were significantly shorter in the CEG group than the DS group. There was no significant difference in terms of reflux symptoms and complications. Conclusion This novel DS technique is a reconstruction method for use after proximal gastrectomy. It did not show a significant clinical benefit. Development of surgical techniques and further study is needed to identify the optimal reconstruction method after proximal gastrectomy.

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Randomized clinical trial comparing long-term quality of life for Billroth IversusRoux-en-Y reconstruction after distal gastrectomy for gastric cancer

Abstract: NCT01065688 (http://www.clinicaltrials.gov).

Cited by 66 publications

References 41 publications

Comparison of quality of life between Billroth-І and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A randomized controlled trial

Comparison of quality of life between Billroth-І and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A randomized controlled trial

Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014

Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy

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