| Abstract | BACKGROUND: In the majority of gastric surgical units across Japan, Billroth 1 is the preferred method of anastomosis following subtotal distal gastrectomy for gastric cancer. However, across Europe and North America, reconstruction using a Roux-en-Y anastomosis is more common. There is a lack of comparative studies of the two methods focusing on long-term outcome. This study evaluated patient outcome, in terms of adverse gastrointestinal complaints and quality of life, at 5 years following surgery. METHODS: A total of 652 patients had a subtotal distal gastrectomy for early gastric cancer between January 1993 and December 1999. We studied 229 patients with reconstruction by the Billroth 1 procedure and 214 patients with the Roux-en-Y procedure. All patients had an abdominal ultrasound and endoscopy as part of their follow-up. Quality of life was assessed by questionnaire. RESULTS: We had an 87% response rate from the questionnaire assessment. The results demonstrated that patients were less likely to experience symptoms of either early or late dumping after Roux-en-Y anastomosis than after Billroth 1. In addition, there were significantly fewer patients with gastritis on endoscopy in the Roux-en-Y group. There was no significant difference in the average relative body weight between the groups. However, patients were more likely to develop gallstones after a Roux-en-Y than after a Billroth 1 reconstruction. CONCLUSION: The results from this study show that, at 5 years, both symptomatically and functionally, Roux-en-Y reconstruction was superior to the Billroth I method after subtotal distal gastrectomy for gastric cancer. However, the overall outcome in both groups was good, with patient satisfaction scores of around 75% in each group. |
| Authors | Souya Nunobe, Abuchi Okaro, Mitsuru Sasako, Makoto Saka, Takeo Fukagawa, Hitoshi Katai, Takeshi Sano
(Affiliation: Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.)
|
| Journal | International journal of clinical oncology / Japan Society of Clinical Oncology
(Int J Clin Oncol)
Vol. 12
Issue 6
Pg. 433-9
(Dec 2007)
ISSN: 1341-9625 Japan |
| PMID | 18071862
(Publication Type: Evaluation Studies, Journal Article, Research Support, Non-U.S. Gov't)
|
| Topics |
- Anastomosis, Roux-en-Y
(adverse effects)
- Female
- Gastrectomy
- Gastroenterostomy
(adverse effects)
- Humans
- Japan
- Male
- Postgastrectomy Syndromes
(diagnosis)
- Quality of Life
- Questionnaires
- Stomach Neoplasms
(surgery)
- Treatment Outcome
|
