Li XG, Song QY, Wu D, Li S, Zhang BL, Zhang LY, Guan D, Wang XX, Liu L. Does the addition of Braun anastomosis to Billroth II reconstruction on laparoscopic-assisted distal gastrectomy benefit patients? World J Gastrointest Oncol 2022; 14(6): 1141-1147 [PMID: 35949212 DOI: 10.4251/wjgo.v14.i6.1141]
Corresponding Author of This Article
Xin-Xin Wang, MD, PhD, Assistant Professor, Chief Doctor, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. 301wxx@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2022; 14(6): 1141-1147 Published online Jun 15, 2022. doi: 10.4251/wjgo.v14.i6.1141
Does the addition of Braun anastomosis to Billroth II reconstruction on laparoscopic-assisted distal gastrectomy benefit patients?
Xiong-Guang Li, Qi-Ying Song, Di Wu, Shuo Li, Ben-Long Zhang, Li-Yu Zhang, Da Guan, Xin-Xin Wang, Lu Liu
Xiong-Guang Li, Qi-Ying Song, Di Wu, Shuo Li, Ben-Long Zhang, Li-Yu Zhang, Da Guan, Xin-Xin Wang, Lu Liu, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Li XG designed the experiment; Song QY and Wu D performed the experiment; Li S and Zhang BL collected data; Zhang LY and Guan D managed data; Liu L created the tables and figures based on data; Li XG, Song QY and Wu D wrote the initial draft; Wang XX modified the draft; Li XG, Song QY and Wu D contributed equally to this article.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of PLA General Hospital (Approval No. S2021-579).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Xin Wang, MD, PhD, Assistant Professor, Chief Doctor, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. 301wxx@sina.com
Received: November 14, 2021 Peer-review started: November 14, 2021 First decision: December 9, 2021 Revised: December 19, 2021 Accepted: May 13, 2022 Article in press: May 13, 2022 Published online: June 15, 2022 Processing time: 207 Days and 20.4 Hours
Abstract
BACKGROUND
Operation is the primary therapeutic option for patients with distal gastrectomy. Braun anastomosis is usually performed after Billroth II reconstruction, which is wildly applied on distal gastrectomy because it is believed to benefit patients. However, studies are needed to confirm that.
AIM
To identify whether the addition of Braun anastomosis to Billroth II reconstruction on laparoscopy-assisted distal gastrectomy benefits patients.
METHODS
A total of 143 patients with gastric cancer underwent laparoscopy-assisted distal gastrectomy at Centre 1 of PLA general hospital between January 2015 and December 2019. Clinical data of the patients were collected, and 93 of the 143 patients were followed up. These 93 patients were divided into two groups: Group 1 (Billroth II reconstruction, 33 patients); and Group 2 (Billroth II reconstruction combined with Braun anastomosis, 60 patients). Postoperative complication follow-up data and relevant clinical data were compared between the two groups.
RESULTS
There were no significant differences between Group 1 and Group 2 in postoperative complications (6.1% vs 6.7%, P = 0.679), anal exhaust time or blood loss. The follow-up prevalence of reflux gastritis indicated no significant difference between Group 1 and Group 2 (68.2% vs 51.7%, P = 0.109). The follow-up European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 scores revealed no evident difference between Group 1 and Group 2 as well. Group 1 had a shorter operating time than Group 2 on average (234.6 min vs 262.0 min, P = 0.017).
CONCLUSION
Combined with Billroth II reconstruction, Braun anastomosis has been applied due to its ability to reduce the prevalence of reflux gastritis. Whereas in this study, the prevalence of reflux gastritis showed no significant difference, leading to a conclusion that under the circumstance of Braun anastomosis costing more time and more money, simple Billroth II reconstruction should be widely applied.
Core Tip: Braun anastomosis is usually performed after Billroth II reconstruction, which is wildly applied on distal gastrectomy because it is believed to benefit patients. This study indicated that the addition of Braun anastomosis to Billroth II reconstruction makes no significant difference in reducing the incidence of reflux gastritis.
