Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: Prospective randomized controlled trial

Sumiya Ishigami, Shoji Natsugoe, Shuichi Hokita, Teruaki Aoki, Hideyuki Kashiwagi, Kosei Hirakawa, Tetsuji Sawada, Yoshitaka Yamamura, Seiji Itoh, Koichi Hirata, Keiichiro Ohta, Kenichi Mafune, Yasushi Nakane, Tatsuo Kanda, Hiroshi Furukawa, Iwao Sasaki, Tetsuro Kubota, Masaki Kitajima, Takashi Aikou

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalAmerican Journal of Surgery
Volume202
Issue number3
DOIs
Publication statusPublished - 2011 Sep

Keywords

  • Gastric cancer
  • Postoperative complication interposition
  • Prospective randomized controlled multicenter trial
  • Quality of life
  • Roux-en-Y
  • Total gastrectomy

ASJC Scopus subject areas

  • Surgery

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