Comparison of long-term quality of life between Billroth-I and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a randomized controlled trial / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 1074-1081, 2023.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-980851
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND@#The results of studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) reconstruction on the quality of life (QoL) are still inconsistent. The aim of this trial was to compare the long-term QoL of B-I with R-Y anastomosis after curative distal gastrectomy for gastric cancer.@*METHODS@#A total of 140 patients undergoing curative distal gastrectomy with D2 lymphadenectomy in West China Hospital, Sichuan University from May 2011 to May 2014 were randomly assigned to the B-I group ( N = 70) and R-Y group ( N = 70). The follow-up time points were 1, 3, 6, 9, 12, 24, 36, 48, and 60 months after the operation. The final follow-up time was May 2019. The clinicopathological features, operative safety, postoperative recovery, long-term survival as well as QoL were compared, among which QoL score was the primary outcome. An intention-to-treat analysis was applied.@*RESULTS@#The baseline characteristics were comparable between the two groups. There were no statistically significant differences in terms of postoperative morbidity and mortality rates, and postoperative recovery between the two groups. Less estimated blood loss and shorter surgical duration were found in the B-I group. There were no statistically significant differences in 5-year overall survival (79% [55/70] of the B-I group vs. 80% [56/70] of the R-Y group, P = 0.966) and recurrence-free survival rates (79% [55/70] of the B-I group vs. 78% [55/70] of the R-Y group, P = 0.979) between the two groups. The scores of the global health status of the R-Y group were higher than those of the B-I group with statistically significant differences (postoperative 1 year 85.4 ± 13.1 vs . 88.8 ± 16.1, P = 0.033; postoperative 3 year 87.3 ± 15.2 vs . 92.8 ± 11.3, P = 0.028; postoperative 5 year 90.9 ± 13.7 vs . 96.4 ± 5.6, P = 0.010), and the reflux (postoperative 3 year 8.8 ± 12.9 vs . 2.8 ± 5.3, P = 0.001; postoperative 5 year 5.1 ± 9.8 vs . 1.8 ± 4.7, P = 0.033) and epigastric pain (postoperative 1 year 11.8 ± 12.7 vs. 6.1 ± 8.8, P = 0.008; postoperative 3 year 9.4 ± 10.6 vs. 4.6 ± 7.9, P = 0.006; postoperative 5 year 6.0 ± 8.9 vs . 2.7 ± 4.6, P = 0.022) were milder in the R-Y group than those of the B-I group at the postoperative 1, 3, and 5-year time points.@*CONCLUSIONS@#Compared with B-I group, R-Y reconstruction was associated with better long-term QoL by reducing reflux and epigastric pain, without changing survival outcomes.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR-TRC-10001434.
Texto completo:
Disponible
Contexto en salud:
ODS3 - Salud y Bienestar
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ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Meta 3.8: Alcanzar cobertura universal de salud
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Meta 3.4: Reducir las muertes prematuras por enfermedades no transmisibles
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Enfermedades del Sistema Digestivo
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Neoplasia del Estómago
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Dolor
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Complicaciones Posoperatorias
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Calidad de Vida
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Neoplasias Gástricas
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Anastomosis en-Y de Roux
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Gastroenterostomía
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Resultado del Tratamiento
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Gastrectomía
Límite:
Humanos
Idioma:
Inglés
Revista:
Chinese Medical Journal
Año:
2023
Tipo del documento:
Artículo