Published online Mar 20, 2024. doi: 10.5662/wjm.v14.i1.89709
Peer-review started: November 9, 2023
First decision: December 12, 2023
Revised: December 21, 2023
Accepted: January 24, 2024
Article in press: January 24, 2024
Published online: March 20, 2024
The study focuses on comparing two reconstruction techniques, Billroth II and Billroth II with Braun anastomosis, commonly used after distal gastrectomy, examining their impact on postoperative outcomes. The retrospective study collected data from patients undergoing distal gastrectomy, dividing them into two groups based on the reconstruction technique used. The significance of our research lies to the close follow-up in accordance with the gastroenterologists to confirm the diagnosis of alkaline reflux gastritis.
The research is motivated by the debate on the optimal reconstruction technique following distal gastrectomy for gastric cancer. The study aims to contribute valuable insights by comparing the postoperative outcomes of the two reconstruction methods, Billroth II and Billroth II with Braun anastomosis, in order to inform clinical decision-making and potentially improve patient outcomes in the treatment of distal gastric cancer.
To evaluate and compare the postoperative course of patients undergoing distal gastrectomy with either Billroth II or Billroth II with Braun anastomosis. Specific outcomes under scrutiny involve factors such as postoperative hospitalization days (PHD), feeding initiation, nasogastric tube (NGT) removal, and the occurrence of complications like bile reflux and alkaline gastritis, aiming to discern potential advantages between the two reconstruction techniques.
The study employed a retrospective design, collecting data from patients who underwent distal gastrectomy at the Department of Surgery, University Hospital of Larissa, spanning from 2002 to 2021. Patients were categorized based on the reconstruction technique used (Billroth II or Billroth II with Braun), and statistical analyses, including Mann-Whitney U test and Aligned Rank Transform three-way ANOVA, were performed to assess variables such as PHD, feeding start day, NGT removal, and complications.
The research revealed that distal gastrectomy with Billroth II and Braun anastomosis demonstrated superiority over typical Billroth II in terms of postoperative outcomes. Statistically significant differences were observed, including shorter PHD, earlier feeding initiation, quicker NGT removal, and a lower incidence of complications such as bile reflux and alkaline gastritis, highlighting potential benefits of the Billroth II and Braun anastomosis technique in the surgical management of distal gastric cancer.
In conclusion, the study suggests evidence of the superiority of Billroth II with Braun anastomosis over typical Billroth II in the context of distal gastrectomy for gastric cancer. Despite inherent limitations in the retrospective design, the findings emphasize the potential benefits of the specific reconstruction technique, such as reduced postoperative complications and improved outcomes.
Future research should focus on addressing limitations such as sample size constraints, variations in surgical techniques, and the absence of quantitative assessments for gastric reflux, aiming to provide more conclusive evidence on the optimal reconstruction method for enhanced postoperative outcomes in patients with distal gastric cancer.