Short- and long-term outcomes of Roux-en-Y and Billroth II with Braun reconstruction in total laparoscopic distal gastrectomy: a retrospective analysis

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Title: Short- and long-term outcomes of Roux-en-Y and Billroth II with Braun reconstruction in total laparoscopic distal gastrectomy: a retrospective analysis
Authors: Yan-xin Chen, Qiao-zhen Huang, Peng-cheng Wang, Yue-Jia Zhu, Li-quan Chen, Chu-ying Wu, Jin-tian Wang, Jun-xing Chen, Kai Ye
Source: World Journal of Surgical Oncology, Vol 21, Iss 1, Pp 1-13 (2023)
Publisher Information: BMC, 2023.
Publication Year: 2023
Collection: LCC:Surgery
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Roux-en-Y, Billroth II with Braun, Bile reflux, Long-term outcomes, Quality of life, Total laparoscopic distal gastrectomy, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background The controversy surrounding Roux-en-Y (R-Y) and Billroth II with Braun (BII + B) reconstruction as an anti-bile reflux procedure after distal gastrectomy has persisted. Recent studies have demonstrated their efficacy, but the long-term outcomes and postoperative quality of life (QoL) among patients have yet to be evaluated. Therefore, we compared the short-term and long-term outcomes of the two procedures as well as QoL. Methods The clinical data of 151 patients who underwent total laparoscopic distal gastrectomy (TLDG) at the Gastrointestinal Surgery Department of the Second Hospital of Fujian Medical University from January 2016 to December 2019 were retrospectively analyzed. Of these, 57 cases with Roux-en-Y procedure (R-Y group) and 94 cases with Billroth II with Braun procedure were included (BII + B group). Operative and postoperative conditions, early and late complications, endoscopic outcomes at year 1 and year 3 after surgery, nutritional indicators, and quality of life scores at year 3 postoperatively were compared between the two groups. Results The R-Y group recorded a significantly longer operative time (194.65 ± 21.52 vs. 183.88 ± 18.02 min) and anastomotic time (36.96 ± 2.43 vs. 27.97 ± 3.74 min) compared to the BII + B group (p 0.05). Both groups showed comparable rates of early and late complications. Endoscopic findings indicated similar food residuals at years 1 and 3 post-surgery for both groups. The R-Y group had a lower occurrence of residual gastritis and bile reflux at year 1 and year 3 after surgery, with a statistically significant difference (p 0.05). Quality of life scores measured by the QLQ-C30 scale were not significantly different between the two groups. However, on the QLQ-STO22 scale, the reflux score was significantly lower in the R-Y group than in the BII + B group (0 [0, 0] vs. 5.56 [0, 11.11]) (p = 0.003). The rest of the scores were not significantly different (p > 0.05). Conclusion Both R-Y and B II + B reconstructions are equally safe and efficient for TLDG. Nevertheless, the R-Y reconstruction reduces the incidence of residual gastritis, bile reflux, and reflux esophagitis, as well as postoperative reflux symptoms, and provides a better quality of life for patients. R-Y reconstruction is superior to BII + B reconstruction for TLDG.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1477-7819
Relation: https://doaj.org/toc/1477-7819
DOI: 10.1186/s12957-023-03249-6
Access URL: https://doaj.org/article/d3a12e7c61d44808890cf3171af26fc5
Accession Number: edsdoj.3a12e7c61d44808890cf3171af26fc5
Database: Directory of Open Access Journals
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More Details
ISSN:14777819
DOI:10.1186/s12957-023-03249-6
Published in:World Journal of Surgical Oncology
Language:English