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Long-term quality of life after distal gastrectomy for gastric cancer: a prospective randomized controlled trial comparing Billroth-I reconstruction with Roux-en-Y reconstruction
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M. Nakamura1,
M. Nakamori1,
H. Yamaue1 |
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1Second Department of Surgery, Wakayama Medical University, School of Medicine |
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| Background: Patients' quality of life (QOL) deteriorates remarkably after gastrectomy. We hypothesized that Billroth-I (B-I) reconstruction would be superior to Roux-en Y (R-Y) reconstruction in terms of long-term QOL after distal gastrectomy. This study compared two reconstructions in a multicenter prospective randomized clinical trial. Methods: Between January 2009 and September 2010, patients who underwent gastrectomy for gastric cancer were intraoperatively randomized to B-I reconstruction or R-Y reconstruction. The primary endpoint was QOL assessment using the FACT-Ga questionnaire at 36 months postoperatively (NCT01065688). Results: One hundred twenty-two patients were enrolled in the study; 60 were randomized to B-I reconstruction and 62 to R-Y reconstruction. There were no significant differences between the two groups in terms of the FACT-Ga total score as the primary endpoint (p=0. 496). Symptom scales such as epigastric fullness (heaviness), diarrhea, and fatigue were significantly better in the B-I group than in the R-Y group at 36 months after gastrectomy (epigastric fullness (heaviness) : p=0.040, diarrhea: p=0.046, fatigue: p=0.029). Moreover, the rate of weight loss in the third year was lower in the B-I group (p=0.046). Conclusions: The reconstruction after distal gastrectomy did not affect long-term QOL. However, B-I reconstruction might contribute to improvement of some postoperative symptoms and body weight loss during a long term after distal gastrectomy. |
Index Term 1: distal gastrectomy
Index Term 2: QOL |
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