TY - JOUR
T1 - Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer
T2 - Prospective randomized controlled trial
AU - Ishigami, Sumiya
AU - Natsugoe, Shoji
AU - Hokita, Shuichi
AU - Aoki, Teruaki
AU - Kashiwagi, Hideyuki
AU - Hirakawa, Kosei
AU - Sawada, Tetsuji
AU - Yamamura, Yoshitaka
AU - Itoh, Seiji
AU - Hirata, Koichi
AU - Ohta, Keiichiro
AU - Mafune, Kenichi
AU - Nakane, Yasushi
AU - Kanda, Tatsuo
AU - Furukawa, Hiroshi
AU - Sasaki, Iwao
AU - Kubota, Tetsuro
AU - Kitajima, Masaki
AU - Aikou, Takashi
PY - 2011/9
Y1 - 2011/9
N2 - Background: The postoperative clinical superiority of the interposition of jejunum reconstruction (INT) to Roux-en-Y reconstruction (RY) after total gastrectomy has not been clarified. Postoperative quality of life (QOL) was evaluated between the 2 methods by a multi-institutional prospective randomized trial. Methods: A total of 103 patients with gastric cancer were prospectively randomly divided into groups for RY (n = 51) or INT reconstruction (n = 52) after total gastrectomy. They were stratified by sex, age, institute, histology, and degree of lymph node dissection. Postoperatively, body mass index (BMI) and nutritional conditions were measured serially, and QOL and postoperative squalor scores were evaluated at 3, 12, and 60 months and compared between the 2 groups. Results: After removing patients who did not complete the follow-up survey or censured cases, 24 patients in the RY group and 18 patients in the INT group were clinically available and their postoperative status was assessed. QOL scores were increased and complication scores were improved in the postoperative periods (P <.01). Postoperative BMI significantly deteriorated compared with preoperative BMI in each group. The postoperative QOL and complication scores at 60 months after surgery were significantly better than those at 3 months after surgery in each group (P <.01). However, there was no significant difference of QOL scores and postoperative complication scores between the 2 reconstruction groups. The nutritional condition in the INT group was nearly the same as that in the RY group. Conclusions: Although our patient sample was small and patients who did not complete the follow-up survey were present, we could not identify any clinical difference between INT and RY after total gastrectomy 60 months after surgery. The safer and simpler RY method may be a more suitable reconstruction method than INT after total gastrectomy.
AB - Background: The postoperative clinical superiority of the interposition of jejunum reconstruction (INT) to Roux-en-Y reconstruction (RY) after total gastrectomy has not been clarified. Postoperative quality of life (QOL) was evaluated between the 2 methods by a multi-institutional prospective randomized trial. Methods: A total of 103 patients with gastric cancer were prospectively randomly divided into groups for RY (n = 51) or INT reconstruction (n = 52) after total gastrectomy. They were stratified by sex, age, institute, histology, and degree of lymph node dissection. Postoperatively, body mass index (BMI) and nutritional conditions were measured serially, and QOL and postoperative squalor scores were evaluated at 3, 12, and 60 months and compared between the 2 groups. Results: After removing patients who did not complete the follow-up survey or censured cases, 24 patients in the RY group and 18 patients in the INT group were clinically available and their postoperative status was assessed. QOL scores were increased and complication scores were improved in the postoperative periods (P <.01). Postoperative BMI significantly deteriorated compared with preoperative BMI in each group. The postoperative QOL and complication scores at 60 months after surgery were significantly better than those at 3 months after surgery in each group (P <.01). However, there was no significant difference of QOL scores and postoperative complication scores between the 2 reconstruction groups. The nutritional condition in the INT group was nearly the same as that in the RY group. Conclusions: Although our patient sample was small and patients who did not complete the follow-up survey were present, we could not identify any clinical difference between INT and RY after total gastrectomy 60 months after surgery. The safer and simpler RY method may be a more suitable reconstruction method than INT after total gastrectomy.
KW - Gastric cancer
KW - Postoperative complication interposition
KW - Prospective randomized controlled multicenter trial
KW - Quality of life
KW - Roux-en-Y
KW - Total gastrectomy
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U2 - 10.1016/j.amjsurg.2011.04.004
DO - 10.1016/j.amjsurg.2011.04.004
M3 - Article
C2 - 21871978
AN - SCOPUS:80052155667
VL - 202
SP - 247
EP - 253
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 3
ER -
