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Reappraisal of optimal reconstruction after distal gastrectomy - a study based on KLASS-07 database

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Author(s)
Shin-Hoo ParkHoon HurJong-Hyun ParkChang-Min LeeYoung-Gil SonMi Ran JungHan Hong LeeSun-Hwi HwangMoon-Soo LeeSang Hyuk SeoIn Ho JeongMyoung Won SonChang Hyun KimMoon-Won YooSung Jin OhSeong Ho HwangSung Il ChoiHyuk Soon ChoiBo-Ra KeumKyung Sook YangSungsoo Park
Keimyung Author(s)
Son, Young Gil
Department
Dept. of Surgery (외과학)
Journal Title
Int J Surg
Issued Date
2023
Volume
110
Issue
1
Abstract
Backgrounds:
This study aimed to compare the incidence of bile reflux, quality of life (QoL), and nutritional status among Billroth II (BII), Billroth II with Braun anastomosis (BII-B), and Roux-en-Y (RY) reconstruction after laparoscopic distal gastrectomy (LDG).

Materials and methods:
We reviewed the prospective data of 397 patients from a multicentre database who underwent LDG for gastric cancer between 2018 and 2020 at 20 tertiary teaching hospitals in Korea. Postoperative endoscopic findings, QoL surveys using the European Organization for Research and Treatment of Cancer questionnaire (C30 and STO22), and nutritional and surgical outcomes were compared among groups.

Results:
In endoscopic findings, bile reflux was the lowest in the RY group ( n =67), followed by the BII-B ( n =183) and BII groups ( n =147) at 1 year (3.0 vs. 67.8 vs. 84.4%, all P <0.05). The anti-reflux capability of BII-B was statistically better than that of BII, but not as perfect as that of RY. From the perspective of QoL, BII-B was not inferior to RY, but better than BII reconstruction in causing fewer STO22 reflux symptoms at 6 and 12 months. However, only RY caused fewer C30 nausea symptoms than BII at 6 and 12 months, but not BII-B. Nutritional status and morbidities were similar among the three groups, and the operative time did not differ between the BII-B and RY groups.

Conclusions:
BII-B cannot substitute for RY in preventing bile reflux, shortening the operative time, or reducing morbidities. Regarding short-term QoL, BII-B was sufficient to reduce STO22 reflux symptoms but failed to reduce C30 nausea symptoms postoperatively.
Keimyung Author(s)(Kor)
손영길
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1743-9159
Source
https://journals.lww.com/international-journal-of-surgery/fulltext/2024/01000/reappraisal_of_optimal_reconstruction_after_distal.5.aspx
DOI
10.1097/JS9.0000000000000796
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45224
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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