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Billroth 1 versus Roux-en-Y reconstructions: a quality-of-life survey at 5 years

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Abstract

Background

In the majority of gastric surgical units across Japan, Billroth 1 is the preferred method of anastomosis following subtotal distal gastrectomy for gastric cancer. However, across Europe and North America, reconstruction using a Roux-en-Y anastomosis is more common. There is a lack of comparative studies of the two methods focusing on long-term outcome. This study evaluated patient outcome, in terms of adverse gastrointestinal complaints and quality of life, at 5 years following surgery.

Methods

A total of 652 patients had a subtotal distal gastrectomy for early gastric cancer between January 1993 and December 1999. We studied 229 patients with reconstruction by the Billroth 1 procedure and 214 patients with the Roux-en-Y procedure. All patients had an abdominal ultrasound and endoscopy as part of their follow-up. Quality of life was assessed by questionnaire.

Results

We had an 87% response rate from the questionnaire assessment. The results demonstrated that patients were less likely to experience symptoms of either early or late dumping after Roux-en-Y anastomosis than after Billroth 1. In addition, there were significantly fewer patients with gastritis on endoscopy in the Roux-en-Y group. There was no significant difference in the average relative body weight between the groups. However, patients were more likely to develop gallstones after a Roux-en-Y than after a Billroth 1 reconstruction.

Conclusion

The results from this study show that, at 5 years, both symptomatically and functionally, Roux-en-Y reconstruction was superior to the Billroth I method after subtotal distal gastrectomy for gastric cancer. However, the overall outcome in both groups was good, with patient satisfaction scores of around 75% in each group.

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Authors and Affiliations

  1. Department of Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo, 104-0045, Japan

    Souya Nunobe, Abuchi Okaro, Mitsuru Sasako, Makoto Saka, Takeo Fukagawa, Hitoshi Katai & Takeshi Sano

Authors
  1. Souya Nunobe
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  2. Abuchi Okaro
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  3. Mitsuru Sasako
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  4. Makoto Saka
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  5. Takeo Fukagawa
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  6. Hitoshi Katai
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  7. Takeshi Sano
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Corresponding author

Correspondence to Mitsuru Sasako.

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Nunobe, S., Okaro, A., Sasako, M. et al. Billroth 1 versus Roux-en-Y reconstructions: a quality-of-life survey at 5 years. Int J Clin Oncol 12, 433–439 (2007). https://doi.org/10.1007/s10147-007-0706-6

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  • DOI: https://doi.org/10.1007/s10147-007-0706-6

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