Roux-en-Y or Billroth II Reconstruction After Radical Distal Gastrectomy for Gastric Cancer A Multicenter Randomized Controlled Trial
Publication in refereed journal

香港中文大學研究人員
替代計量分析
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其它資訊
摘要Objective: The aim of the study was to compare the clinical symptoms between Billroth II (B-II) and Roux-en-Y (R-Y) reconstruction after distal subtotal gastrectomy (DG) for gastric cancer.Background: Surgery is the mainstay of curative treatment for gastric cancer. The technique for reconstruction after DG remains controversial. Both B-II and R-Y are popular methods.

Methods: This is a prospective multicenter randomized controlled trial. From October 2008 to October 2014, 162 patients who underwent DG were randomly allocated to B-II (n = 81) and R-Y (n = 81) groups. The primary endpoint is Gastrointestinal (GI) Symptoms Score 1 year after surgery. We also compared the nutritional status, extent of gastritis on endoscopy, and quality of life after surgery between the 2 procedures at 1 year.

Results: Operative time was significantly shorter for B-II than for R-Y [mean difference 21.5minutes, 95% confidence interval (95% CI) 3.8-39.3, P = 0.019]. The B-II and R-Y groups had a peri-operative morbidity of 28.4% and 33.8%, respectively (P = 0.500) and a 30-day mortality of 2.5% and 1.2%, respectively (P = 0.500). GI symptoms score did not differ between R-Y versus B-II reconstruction (mean difference -0.45, 95% CI -1.21 to 0.31, P = 0.232). R-Y resulted in a lower median endoscopic grade for gastritis versus B-II (mean difference -1.32, 95% CI -1.67 to -0.98, P < 0.001). We noted no difference in nutritional status (R-Y versus B-II mean difference -0.31, 95% CI -3.27 to 2.65, P = 0.837) and quality of life at 1 year between the 2 groups too.

Conclusion: Although BII is associated with a higher incidence of heartburn symptom and higher median endoscopic grade for gastritis, BII and RY are similar in terms of overall GI symptom score and nutritional status at 1 year after distal gastrectomy.
著者So JB, Rao J, Wong AS, Chan YH, Pang NQ, Tay AYL, Yung MY, Su Z, Phua JNS, Shabbir A, Ng EKW
期刊名稱Annals of Surgery
出版年份2018
月份2
卷號267
期次2
頁次236 - 242
國際標準期刊號0003-4932
電子國際標準期刊號1528-1140
語言英式英語

上次更新時間 2020-06-08 於 02:34