Open AccessComparison of 5‐year postoperative outcomes after Billroth I and Roux‐en‐Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi‐institutional randomized controlled trial
Author(s) -
Kimura Yutaka,
Mikami Jota,
Yamasaki Makoto,
Hirao Motohiro,
Imamura Hiroshi,
Fujita Junya,
Takeno Atsushi,
Matsuyama Jin,
Kishi Kentaro,
Hirao Takafumi,
Fukunaga Hiroki,
Demura Koichi,
Kurokawa Yukinori,
Takiguchi Shuji,
Eguchi Hidetoshi,
Doki Yuichiro
Publication year - 2021
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12400
Subject(s) - medicine , billroth i , gastrectomy , roux en y anastomosis , billroth ii , gastroenterology , anastomosis , cancer , randomized controlled trial , gastroenterostomy , surgery , weight loss , gastric bypass , obesity
Aim We previously reported in a randomized controlled trial that Billroth I and Roux‐en‐Y reconstructions were generally equivalent regarding body weight change and nutritional status 1 year after distal gastrectomy for gastric cancer. We describe the long‐term follow‐up data 5 years after distal gastrectomy. Methods We analyzed consecutive gastric cancer patients who were randomly assigned to undergo Billroth I or Roux‐en‐Y reconstruction after distal gastrectomy. We evaluated body weight change, nutritional status, late complications, quality of life (QOL) using the European Organization for Research and Treatment of Cancer Core QOL Questionnaire, and dysfunction using the Dysfunction After Upper Gastrointestinal Surgery for Cancer, 5 years after surgery. Results A total of 228 patients (Billroth I = 105; Roux‐en‐Y = 123) were eligible for efficacy analyses in this study. Body weight loss 5 years after surgery did not differ significantly between the Billroth I and Roux‐en‐Y groups (10.0% ± 7.9% and 9.6% ± 8.4%, respectively; P = .70). There were no significant differences in other aspects of nutritional status between the two groups. Reflux esophagitis occurred in 19.0% of the patients in the Billroth I group vs 4.9% in the Roux‐en‐Y group ( P = .002). Regarding QOL, Billroth I was significantly inferior to Roux‐en‐Y on the diarrhea scale (Billroth I: 28.6, Roux‐en‐Y: 16.0; P = .047). Regarding dysfunction, no score differed significantly between the two groups. Conclusions Billroth I and Roux‐en‐Y reconstructions were generally equivalent regarding body weight change, nutritional status, and QOL 5 years after distal gastrectomy, although Roux‐en‐Y more effectively prevented reflux esophagitis and diarrhea.