Randomized clinical trial comparing long-term quality of life for Billroth I versus Roux-en-Y reconstruction after distal gastrectomy for gastric cancer
- PMID: 26840944
- DOI: 10.1002/bjs.10060
Randomized clinical trial comparing long-term quality of life for Billroth I versus Roux-en-Y reconstruction after distal gastrectomy for gastric cancer
Abstract
Background: Patients' quality of life (QoL) deteriorates remarkably after gastrectomy. Billroth I reconstruction following distal gastrectomy has the physiological advantage of allowing food to pass through the duodenum. It was hypothesized that Billroth I reconstruction would be superior to Roux-en-Y reconstruction in terms of long-term QoL after distal gastrectomy. This study compared two reconstructions in a multicentre prospective randomized clinical trial to identify the optimal reconstruction procedure.
Methods: Between January 2009 and September 2010, patients who underwent gastrectomy for gastric cancer were randomized during surgery to Billroth I or Roux-en-Y reconstruction. The primary endpoint was assessment of QoL using the Functional Assessment of Cancer Therapy - Gastric (FACT-Ga) questionnaire 36 months after surgery.
Results: A total of 122 patients were enrolled in the study, 60 to Billroth I and 62 to Roux-en-Y reconstruction. There were no differences between the two groups in terms of postoperative complications or mortality, and no significant differences in FACT-Ga total score (P = 0·496). Symptom scales such as epigastric fullness (heaviness), diarrhoea and fatigue were significantly better in the Billroth I group at 36 months after gastrectomy (heaviness, P = 0·040; diarrhoea, P = 0·046; fatigue, P = 0·029). The rate of weight loss in the third year was lower for patients in the Billroth I group (P = 0·046).
Conclusion: The choice of anastomotic reconstruction after distal gastrectomy resulted in no difference in long-term QoL in patients with gastric cancer.
Registration number: NCT01065688 (http://www.clinicaltrials.gov).
© 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.
Similar articles
-
To Roux or not to Roux: a comparison between Roux-en-Y and Billroth II reconstruction following partial gastrectomy for gastric cancer.Gastric Cancer. 2016 Jul;19(3):994-1001. doi: 10.1007/s10120-015-0547-3. Epub 2015 Sep 23. Gastric Cancer. 2016. PMID: 26400843
-
Is Roux-en-Y or Billroth-II reconstruction the preferred choice for gastric cancer patients undergoing distal gastrectomy when Billroth I reconstruction is not applicable? A meta-analysis.Medicine (Baltimore). 2019 Nov;98(48):e17093. doi: 10.1097/MD.0000000000017093. Medicine (Baltimore). 2019. PMID: 31770192 Free PMC article.
-
Short- and long-term outcomes of Roux-en-Y and Billroth II with Braun reconstruction in total laparoscopic distal gastrectomy: a retrospective analysis.World J Surg Oncol. 2023 Nov 22;21(1):361. doi: 10.1186/s12957-023-03249-6. World J Surg Oncol. 2023. PMID: 37990273 Free PMC article.
-
Optimal reconstruction methods after distal gastrectomy for gastric cancer: A systematic review and network meta-analysis.Medicine (Baltimore). 2018 May;97(20):e10823. doi: 10.1097/MD.0000000000010823. Medicine (Baltimore). 2018. PMID: 29768387 Free PMC article.
-
Comparison of Quality of Life and Nutritional Status of Between Roux-en-Y and Billroth-I Reconstruction After Distal Gastrectomy: A Systematic Review and Meta-Analysis.Nutr Cancer. 2020;72(5):849-857. doi: 10.1080/01635581.2019.1656262. Epub 2019 Aug 28. Nutr Cancer. 2020. PMID: 31460799
Cited by
-
Comparison of effects of six main gastrectomy procedures on patients' quality of life assessed by Postgastrectomy Syndrome Assessment Scale-45.World J Gastrointest Surg. 2021 May 27;13(5):461-475. doi: 10.4240/wjgs.v13.i5.461. World J Gastrointest Surg. 2021. PMID: 34122736 Free PMC article.
-
Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy.J Minim Invasive Surg. 2020 Dec 15;23(4):191-196. doi: 10.7602/jmis.2020.23.4.191. J Minim Invasive Surg. 2020. PMID: 35601637 Free PMC article.
-
Time interval after various types of gastrectomy until metachronous multiple gastric cancer: Analysis of data from a nationwide Japanese survey.Mol Clin Oncol. 2022 Feb;16(2):54. doi: 10.3892/mco.2021.2487. Epub 2021 Dec 27. Mol Clin Oncol. 2022. PMID: 35070303 Free PMC article.
-
Long-term Functional and Patient-reported Outcomes Between Intra-corporeal Delta-shaped Gastroduodenostomy and Gastrojejunostomy After Laparoscopic Distal Gastrectomy.J Gastric Cancer. 2023 Oct;23(4):561-573. doi: 10.5230/jgc.2023.23.e35. J Gastric Cancer. 2023. PMID: 37932223 Free PMC article.
-
[Reconstruction following gastrectomy].Chirurg. 2021 Jun;92(6):506-514. doi: 10.1007/s00104-020-01350-0. Epub 2021 Jan 26. Chirurg. 2021. PMID: 33496813 Review. German.
Publication types
MeSH terms
Associated data
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials