Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Long-term Functional and Patient-reported Outcomes Between Intra-corporeal Delta-shaped Gastroduodenostomy and Gastrojejunostomy After Laparoscopic Distal Gastrectomy

  • Sin Hye Park (Center for Gastric Cancer, National Cancer Center) ;
  • Hong Man Yoon (Center for Gastric Cancer, National Cancer Center) ;
  • Keun Won Ryu (Center for Gastric Cancer, National Cancer Center) ;
  • Young-Woo Kim (Center for Gastric Cancer, National Cancer Center) ;
  • Mira Han (Biostatistics Collaboration Team, National Cancer Center) ;
  • Bang Wool Eom (Center for Gastric Cancer, National Cancer Center)
  • Received : 2023.04.07
  • Accepted : 2023.09.04
  • Published : 2023.10.31
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Abstract

Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer. Materials and Methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores. Confounding variables included age, sex, body mass index, physical status classification, tumor location, and T classification. Postoperative complications, nutritional outcomes, endoscopic findings, and quality of life (QoL) were compared between the 2 groups. Results: No significant differences in postoperative complications or nutritional parameters between the two groups were observed. Annual endoscopic findings revealed more residual food and less bile reflux in the delta group (P<0.001) than in the Billroth II group. Changes of QoL were significantly different regarding emotional function, insomnia, diarrhea, reflux symptoms, and dry mouth (P=0.007, P=0.002, P=0.013, P=0.001, and P=0.03, respectively). Among them, the delta group had worse insomnia, reflux symptoms, and dry mouth within three months postoperatively. Conclusions: Long-term nutritional outcomes and QoL were comparable between the delta and Billroth II groups. However, more residual food and worse short-term QoL regarding insomnia, reflux symptoms, and dry mouth were observed in the delta group. Longer fasting time before endoscopic evaluation and short-term symptom management would have been helpful for the delta group.

Keywords

Acknowledgement

This study was supported by the National Cancer Center, Republic of Korea, Grant No. 2310270.

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