Abstract
Studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) anastomosis are still lacking and inconsistent. The aim of this trial was to compare the quality of life (QoL) of B-I with R-Y reconstruction after curative distal gastrectomy for gastric cancer. A total of 140 patients were randomly assigned to the B-I group (N = 70) and R-Y group (N = 70) with the comparable baseline characteristics. The overall postoperative morbidity rates were 18.6% and 25.7% in the B-I group and R-Y group without significant difference. More estimated blood loss and longer surgical duration were found in the R-Y group. At the postoperative 1 year time point, the B-I group had a higher score in pain, but lower score in global health. However, the R-Y anastomosis was associated with lower incidence of reflux symptoms at postoperative 6 months (P = 0.002) and postoperative 9 months (P = 0.007). The multivariable analyses of variance did not show any interactions between the time trend and grouping. For the results of endoscopic examination, the degree and extent of remnant gastritis were milder significantly in the R-Y group. The stronger anti-reflux capability of R-Y anastomosis contributes to the higher QoL by reducing the reflux related gastritis and pain symptoms, and promotes a better global health.
Highlights
Studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) anastomosis are still lacking and inconsistent
From May, 2011 to May, 2014, a total of 140 gastric cancer patients who underwent distal gastrectomy were randomly assigned to the B-I group (N = 70) and R-Y group (N = 70)
Our results showed that there was no perioperative mortality in either group, and the morbidity and postoperative recovery were comparable between the two groups
Summary
Studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) anastomosis are still lacking and inconsistent. The aim of this trial was to compare the quality of life (QoL) of B-I with R-Y reconstruction after curative distal gastrectomy for gastric cancer. At the postoperative 1 year time point, the B-I group had a higher score in pain, but lower score in global health. Patients undergoing B-I reconstruction frequently suffer from the reflux symptoms, which could cause remnant gastritis and esophagitis, even increase the possibility of remnant gastric cancer or esophageal cancer[6, 7]. There was no study to dynamically compare the QoL of B-I with R-Y reconstruction by standard questionnaires at multiple time points
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