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Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: prospective randomized controlled trial.
Am J Surg. 2011 Sep; 202(3):247-53.AJ

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.

Authors+Show Affiliations

Office of the Japanese Society for Gastro-surgical Pathophysiology Groups, Department of Digestive Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. ishiga@m.kufm.kagoshima-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

21871978

Citation

Ishigami, Sumiya, et al. "Postoperative Long-term Evaluation of Interposition Reconstruction Compared With Roux-en-Y After Total Gastrectomy in Gastric Cancer: Prospective Randomized Controlled Trial." American Journal of Surgery, vol. 202, no. 3, 2011, pp. 247-53.
Ishigami S, Natsugoe S, Hokita S, et al. Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: prospective randomized controlled trial. Am J Surg. 2011;202(3):247-53.
Ishigami, S., Natsugoe, S., Hokita, S., Aoki, T., Kashiwagi, H., Hirakawa, K., Sawada, T., Yamamura, Y., Itoh, S., Hirata, K., Ohta, K., Mafune, K., Nakane, Y., Kanda, T., Furukawa, H., Sasaki, I., Kubota, T., Kitajima, M., & Aikou, T. (2011). Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: prospective randomized controlled trial. American Journal of Surgery, 202(3), 247-53. https://doi.org/10.1016/j.amjsurg.2011.04.004
Ishigami S, et al. Postoperative Long-term Evaluation of Interposition Reconstruction Compared With Roux-en-Y After Total Gastrectomy in Gastric Cancer: Prospective Randomized Controlled Trial. Am J Surg. 2011;202(3):247-53. PubMed PMID: 21871978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: 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 - 2010/11/22/received PY - 2011/04/28/revised PY - 2011/04/28/accepted PY - 2011/8/30/entrez PY - 2011/8/30/pubmed PY - 2011/10/14/medline SP - 247 EP - 53 JF - American journal of surgery JO - Am J Surg VL - 202 IS - 3 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. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/21871978/Postoperative_long_term_evaluation_of_interposition_reconstruction_compared_with_Roux_en_Y_after_total_gastrectomy_in_gastric_cancer:_prospective_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(11)00376-X DB - PRIME DP - Unbound Medicine ER -