title: Clinical outcomes and quality of life according to types of reconstruction following laparoscopy-assisted distal gastrectomy for gastric cancer.
abstract: OBJECTIVE
  Laparoscopy-assisted distal gastrectomy (LADG) has gained wide acceptance and is being more commonly performed at the period of introduction. This study was designed to determine the clinical outcomes and quality of life (QOL) according to types of reconstruction following LADG for gastric cancer.
  
  
  METHODS
  Between 2007 and 2010, 117 consecutive patients underwent LADG. These patients were classified into 2 groups: Billroth-I group (n=74) and Roux-en-Y group (n=48).
  
  
  RESULTS
  Although there were no significant differences in background factors such as sex, body mass index, pN stage, pT stage, or extent of lymphadenectomy between both the groups, patients with Billroth-I reconstruction were found more frequently in the lower portion of gastric cancer (P=0.0173), shorter surgical durations (P<0.0001), and less blood loss (P<0.0001). The overall postoperative complication rates did not significantly differ between both the groups (P=0.0675). However, the incidence of patients with postoperative stasis (P=0.0170) and long hospital stay (P=0.0039) was significantly higher in patients with Roux-en-Y reconstruction. Concerning the evaluation of long-term QOL using the Gastrointestinal Symptom Rating Scale, there were no significant differences in total score between both the groups (P=0.4387).
  
  
  CONCLUSIONS
  Billroth-I technique might comparatively be accessible and safe in the reconstruction of LADG. However, the differences of reconstruction do not affect long-term QOL.
authors.affiliation: Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimura
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Chohei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005763:Gastroenterostomy / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D063189:Symptom Assessment; D016896:Treatment Outcome
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