Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy

Table 1 Patients’ clinicopathologic characteristics¹

	TP1 (n = 283)	TP2A (n = 102)	TP2B (n = 134)	P value
Median age (range)	59 (26-80)	62 (30-79)	60 (35-82)	0.542
Sex (M/F)	195/88	67/35	75/59	0.23
Type of reconstruction				0.001
Billroth II	283	0	0
Roux-en-Y	0	102	134
Lymphadenectomy				0.153
D1	24 (8.4)	5 (5.2)	14 (10.4)
D2	259 (91.6)	97 (94.8)	120 (89.6)
AJCC tumor stage				0.116
I	41 (14.5)	12 (11.3)	20 (15.2)
II	80 (28.4)	31 (30.4)	45 (33.4)
III	133 (46.9)	51 (50.2)	58 (43.1)
IV	29 (10.2)	8 (8.1)	11 (8.3)
Type of pain control				0.731
Nil	18 (6.3)	5 (4.8)	11 (8.2)
Epidural form	70 (24.9)	22 (21.3)	22 (16.5)
Intravenous form	189 (68.8)	73 (71.9)	101 (75.3)
Operation time	241 ± 53.8	253 ± 59.6	251 ± 63.3	0.821

¹Data are medians with ranges in parentheses, numbers with percentages in parentheses or mean ± SD. AJCC: American Joint Committee on Cancer (6th edition).

Table 2 Postoperative clinical parameters (mean ± SD)¹

	TP1 (n = 283)	TP2A (n = 102)	TP2B (n = 134)	P value
Persistent decompression > 7 d or reinsertion of NG tube, number of patients	19 (6.7%)	3 (2.9%)	5 (3.7%)	0.001
Duration of gastric decompression (d)1	5.3 ± 3.3	3.6 ± 2.2	–	0.023
Amount of gastric decompression (mL/d)	465 ± 241	58 ± 47	–	0.001
Days to passage of flatus	5.1 ± 1.7	4.4 ± 1.3	4.7 ± 1.2	0.618
Days to semi-liquid diet	7.2 ± 1.3	5.9 ± 1.2	4.4 ± 1.4	0.05
Length of postoperative hospital stay (d)	15.4 ± 4.3	12.6 ± 3.1	11.4 ± 3.4	0.035

¹Average amount of nasogastric drainage in the first three postoperative days. NG: Nasogastric.

Table 3 Comparison of postoperative complications n (%)

	TP1 (n = 283)	TP2A (n = 102)	TP2B (n = 134)	P value
Perioperative mortality	11	0	0	NS
Intra-abdominal complications
Delayed gastric emptying or Roux stasis syndrome	6 (2.1)	3 (2.9)	3 (2.2)	NS
Mechanical small bowel obstruction	1 (0.4)	0	1 (0.7)	NS
Gastrojejunostomy leakage	3 (1.1)	1 (1.0)	1 (0.7)	NS
Duodenal stump leakage	2 (0.7)	0	1 (0.7)	NS
Postoperative infection
Wound infection	10 (3.5)	3 (2.9)	4 (3.0)	NS
Unknown fever	9 (3.2)	4 (3.9)	3 (2.2)	NS
Intra-abdominal abscess	1 (0.4)	0 (0)	0 (0)	NS
Pneumonia	13 (4.6)	4 (3.9)	2 (1.4)	0.01
Severe sore throat	59 (20.7)	18 (17.4)	3 (2.1)	0.001

¹Mortality is associated with aspiration pneumonia-related sepsis. NG: Nasogastric.