Reappraisal of optimal reconstruction after distal gastrectomy – a study based on the KLASS-07 database

Shin‐Hoo Park; Hoon Hur; Jong-Hyun Park; Chang Min Lee; Young‐Gil Son; Mi Ran Jung; Han Hong Lee; Sun-Hwi Hwang; Moon-Soo Lee; Sang Hyuk Seo; In Ho Jeong; Myoung Won Son; Chang Hyun Kim; Moon‐Won Yoo; Sung Jin Oh; Seong Ho Hwang; Sung Il Choi; Hyuk Soon Choi; Bora Keum; Kyung‐Sook Yang; Sung Soo Park

doi:10.1097/js9.0000000000000796

Key Points

To compare bile reflux incidence, quality of life, and nutritional outcomes among Billroth II, Billroth II with Braun anastomosis, and Roux-en-Y reconstructions following laparoscopic distal gastrectomy.
Reviewed prospective multicenter database data of 397 patients undergoing laparoscopic distal gastrectomy for gastric cancer across 20 tertiary teaching hospitals in Korea between 2018 and 2020.
Compared outcomes across Billroth II (n=147), Billroth II with Braun anastomosis (n=183), and Roux-en-Y (n=67) reconstruction groups.
Evaluated 1-year postoperative endoscopic bile reflux, EORTC QLQ-C30 and STO22 quality-of-life surveys at 6 and 12 months, and surgical complications.
Endoscopic bile reflux at 1 year was lowest with Roux-en-Y (3.0%, n=67), compared to Billroth II with Braun anastomosis (67.8%, n=183) and Billroth II (84.4%, n=147; all P < 0.05).
Billroth II with Braun anastomosis was not inferior to Roux-en-Y and outperformed Billroth II in reducing STO22 reflux symptoms at 6 and 12 months, but only Roux-en-Y significantly reduced C30 nausea symptoms compared to Billroth II.
Nutritional status and postoperative morbidity rates did not differ significantly among the three groups, and operative time was similar between Braun anastomosis and Roux-en-Y.

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Implication

Prospective cohort study reveals Roux-en-Y reconstruction prevents bile reflux better than Braun anastomosis in distal gastrectomy, highlighting Roux-en-Y advantages.

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Park et al. (2023) studied this question.

synapsesocial.com/papers/6a71577a35aa2c282ce2a5d8 https://doi.org/10.1097/js9.0000000000000796

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Reappraisal of optimal reconstruction after distal gastrectomy – a study based on the KLASS-07 database

Key Points

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Implication

Discussion

Cite This Study

Reappraisal of optimal reconstruction after distal gastrectomy – a study based on the KLASS-07 database

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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