Abstract
Background
Gastric cancer is a major public health problem around the globe. With the standardization of tumor treatment, surgery continues to be the most important treatment method for gastric cancer. However, changes in body composition and nutrition index parameters in patients with Billroth II and Roux-en-Y anastomosis following totally laparoscopic distal gastrectomy (TLDG) remain unclear.
Methods
This was a single-center retrospective study. A total of 369 patients who underwent TLDG at the First Affiliated Hospital of Soochow University (Suzhou, China) between January 2016 and February 2019 were included and assigned to the Billroth II group or Roux-en-Y group according to the anastomosis method. After propensity score matching, body composition and relevant clinical data were compared between the two groups.
Results
The operation time for the Billroth II group was significantly shorter than for the Roux-en-Y group (174.12 ± 39.33 min vs. 229.19 ± 28.12 min, P < 0.001). In addition, the Billroth II group showed lower skeletal muscle loss. Specifically, the Billroth II group showed a − 4.77 ± 4.88% change in the skeletal muscle index (SMI), whereas the Roux-en-Y group showed a − 11.89 ± 8.68% change (P = 0.001). The Billroth II group also showed a smaller decrease in BMI than the Roux-en-Y group (− 6.67 ± 7.76% vs. − 13.12 ± 10.79%, P = 0.018).
Conclusions
These results suggest that Billroth II anastomosis after TLDG has advantages over Roux-en-Y for maintaining patient body composition, especially in terms of SMI, and may serve as a useful reference when choosing an anastomosis method.
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This study was not funded. Author Jiawen Zhang declares that he has no conflict of interest. Author Linhua Jiang declares that he has no conflict of interest. Author **nguo Zhu declares that he has no conflict of interest. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University. This project was conducted as a retrospective observational study; the study protocol involved minimal risk and did not threaten the health of the subjects. And, all participating patients signed informed consents. This project was conducted in compliance with the spirit of the “Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects” (as amended in Fortaleza, October 2013).
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Jiang, L., Zhang, J. & Zhu, X. Billroth II anastomosis maintains SMI and BMI better than Roux-en-Y anastomosis following totally laparoscopic distal gastrectomy: a propensity score-matched study. Langenbecks Arch Surg 407, 1441–1450 (2022). https://doi.org/10.1007/s00423-022-02459-y
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DOI: https://doi.org/10.1007/s00423-022-02459-y