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

Cheng-Jueng Chen, Tsang-Pai Liu, Jyh-Cherng Yu, Sheng-Der Hsua, Tsai-Yuan Hsieh, Heng-Cheng Chu, Chung-Bao Hsieh, Teng-Wei Chen, De-Chuan Chan

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery. METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (B II) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression. RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet wzas significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with B II reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in B II group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the B II group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the B II group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001). CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy. © 2012 Baishideng. All rights reserved.
Original languageEnglish
Pages (from-to)251-256
Number of pages6
JournalWorld Journal of Gastroenterology
Volume18
Issue number3
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Gastrectomy
Decompression
Gastroenterostomy
Stomach
Pharyngitis
Anastomotic Leak
Gastric Bypass
Stomach Neoplasms
Length of Stay
Pneumonia
Diet

Keywords

  • Billroth II gastrojejunostomy
  • Gastric cancer
  • Nasogastric decompression
  • Radical distal gastrectomy
  • Roux-en-Y gastrojejunostomy
  • adult
  • aged
  • anastomosis leakage
  • article
  • cancer surgery
  • controlled study
  • disease severity
  • female
  • gastrectomy
  • gastrectomy Billroth II
  • human
  • length of stay
  • major clinical study
  • male
  • nasogastric decompression
  • pneumonia
  • postoperative period
  • retrospective study
  • Roux Y anastomosis
  • sore throat
  • stomach cancer
  • stomach disease
  • gastroenterostomy
  • methodology
  • middle aged
  • postoperative complication
  • stomach
  • stomach tumor
  • treatment outcome
  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y
  • Female
  • Gastrectomy
  • Gastroenterostomy
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Postoperative Period
  • Retrospective Studies
  • Stomach
  • Stomach Neoplasms
  • Treatment Outcome

Cite this

Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy. / Chen, Cheng-Jueng; Liu, Tsang-Pai; Yu, Jyh-Cherng; Hsua, Sheng-Der; Hsieh, Tsai-Yuan; Chu, Heng-Cheng; Hsieh, Chung-Bao; Chen, Teng-Wei; Chan, De-Chuan.

In: World Journal of Gastroenterology, Vol. 18, No. 3, 2012, p. 251-256.

Research output: Contribution to journalArticle

Chen, C-J, Liu, T-P, Yu, J-C, Hsua, S-D, Hsieh, T-Y, Chu, H-C, Hsieh, C-B, Chen, T-W & Chan, D-C 2012, 'Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy', World Journal of Gastroenterology, vol. 18, no. 3, pp. 251-256. https://doi.org/10.3748/wjg.v18.i3.251
Chen, Cheng-Jueng ; Liu, Tsang-Pai ; Yu, Jyh-Cherng ; Hsua, Sheng-Der ; Hsieh, Tsai-Yuan ; Chu, Heng-Cheng ; Hsieh, Chung-Bao ; Chen, Teng-Wei ; Chan, De-Chuan. / Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 3. pp. 251-256.
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abstract = "AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery. METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (B II) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression. RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet wzas significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with B II reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in B II group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the B II group (1.4{\%} vs 4.6{\%}, P = 0.01). Severe sore throat was noted in 59 (20.7{\%}) members of the B II group, 18 (17.4{\%}) members of the decompressed RY group and 6 (4.2{\%}) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001). CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy. {\circledC} 2012 Baishideng. All rights reserved.",
keywords = "Billroth II gastrojejunostomy, Gastric cancer, Nasogastric decompression, Radical distal gastrectomy, Roux-en-Y gastrojejunostomy, adult, aged, anastomosis leakage, article, cancer surgery, controlled study, disease severity, female, gastrectomy, gastrectomy Billroth II, human, length of stay, major clinical study, male, nasogastric decompression, pneumonia, postoperative period, retrospective study, Roux Y anastomosis, sore throat, stomach cancer, stomach disease, gastroenterostomy, methodology, middle aged, postoperative complication, stomach, stomach tumor, treatment outcome, Adult, Aged, Aged, 80 and over, Anastomosis, Roux-en-Y, Female, Gastrectomy, Gastroenterostomy, Humans, Male, Middle Aged, Postoperative Complications, Postoperative Period, Retrospective Studies, Stomach, Stomach Neoplasms, Treatment Outcome",
author = "Cheng-Jueng Chen and Tsang-Pai Liu and Jyh-Cherng Yu and Sheng-Der Hsua and Tsai-Yuan Hsieh and Heng-Cheng Chu and Chung-Bao Hsieh and Teng-Wei Chen and De-Chuan Chan",
note = "被引用次數:6 Export Date: 22 March 2016 CODEN: WJGAF 通訊地址: Chan, D.-C.; Division of General Surgery, Tri-Service General Hospital, No. 325, Sec. 2, Cheng-Kung Rd., Neihu, 11490 Taipei, Taiwan; 電子郵件: chrischan1168@yahoo.com.tw 參考文獻: Wu, C.C., Hwang, C.R., Liu, T.J., There is no need for nasogastric decompression after partial gastrectomy with extensive lymphadenectomy (1994) Eur J Surg, 160, pp. 369-373; Hsu, S.D., Yu, J.C., Chen, T.W., Chou, S.J., Hsieh, H.F., Chan, D.C., Role of Nasogastric Tube Insertion after Gastrectomy (2007) Chir Gastroenterol, 23, pp. 303-306; Yoo, C.H., Son, B.H., Han, W.K., Pae, W.K., Nasogastric decompression is not necessary in operations for gastric cancer: Prospective randomised trial (2002) Eur J Surg, 168, pp. 379-383; Lee, J.H., Hyung, W.J., Noh, S.H., Comparison of gastric cancer surgery with versus without nasogastric decompression (2002) Yonsei Med J, 43, pp. 451-456; Doglietto, G.B., Papa, V., Tortorelli, A.P., Bossola, M., Covino, M., Pacelli, F., Nasojejunal tube placement after total gastrectomy: A multicenter prospective randomized trial (2004) Arch Surg, 139, pp. 1309-1313. , discussion 1313; Chan, D.C., Fan, Y.M., Lin, C.K., Chen, C.J., Chen, C.Y., Chao, Y.C., Roux-en-Y reconstruction after distal gastrectomy to reduce enterogastric reflux and Helicobacter pylori infection (2007) J Gastrointest Surg, 11, pp. 1732-1740; Horan, T.C., Gaynes, R.P., Martone, W.J., Jarvis, W.R., Emori, T.G., CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections (1992) Infect Control Hosp Epidemiol, 13, pp. 606-608; Braga, M., Costantini, E., di Francesco, A., Gianotti, L., Baccari, P., di Carlo, V., Impact of thymopentin on the incidence and severity of postoperative infection: A randomized controlled trial (1994) Br J Surg, 81, pp. 205-208; Fujita, T., Katai, H., Morita, S., Saka, M., Fukagawa, T., Sano, T., Short-term outcomes of Roux-en-Y stapled anastomosis after distal gastrectomy for gastric adenocarcinoma (2010) J Gastrointest Surg, 14, pp. 289-294; Nathan, B.N., Pain, J.A., Nasogastric suction after elective abdominal surgery: A randomised study (1991) Ann R Coll Surg Engl, 73, pp. 291-294; Lei, W.Z., Zhao, G.P., Cheng, Z., Li, K., Zhou, Z.G., Gastrointestinal decompression after excision and anastomosis of lower digestive tract (2004) World J Gastroenterol, 10, pp. 1998-2001; Guyton, A.C., (2000) Textbook of Medical Physiology, , 10th ed. Philadelphia: W.B. Saunders, Inc; Hoffmann, S., Koller, M., Plaul, U., Stinner, B., Gerdes, B., Lorenz, W., Rothmund, M., Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: A prospective, randomized trial comparing patients' tube-related inconvenience (2001) Langenbecks Arch Surg, 386, pp. 402-409; Manning, B.J., Winter, D.C., McGreal, G., Kirwan, W.O., Redmond, H.P., Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy (2001) Surgery, 130, pp. 788-791; Cheatham, M.L., Chapman, W.C., Key, S.P., Sawyers, J.L., A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy (1995) Ann Surg, pp. 469-476. , discussion 476-478; Wolff, B.G., Pembeton, J.H., van Heerden, J.A., Beart, R.W., Nivatvongs, S., Devine, R.M., Dozois, R.R., Ilstrup, D.M., Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial (1989) Ann Surg, 209, pp. 670-673. , discussion 670-673; Trepanier, C.A., Isabel, L., Perioperative gastric aspiration increases postoperative nausea and vomiting in outpatients (1993) Can J Anesthesia, 40, pp. 325-328",
year = "2012",
doi = "10.3748/wjg.v18.i3.251",
language = "English",
volume = "18",
pages = "251--256",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "3",

}

TY - JOUR

T1 - Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy

AU - Chen, Cheng-Jueng

AU - Liu, Tsang-Pai

AU - Yu, Jyh-Cherng

AU - Hsua, Sheng-Der

AU - Hsieh, Tsai-Yuan

AU - Chu, Heng-Cheng

AU - Hsieh, Chung-Bao

AU - Chen, Teng-Wei

AU - Chan, De-Chuan

N1 - 被引用次數:6 Export Date: 22 March 2016 CODEN: WJGAF 通訊地址: Chan, D.-C.; Division of General Surgery, Tri-Service General Hospital, No. 325, Sec. 2, Cheng-Kung Rd., Neihu, 11490 Taipei, Taiwan; 電子郵件: chrischan1168@yahoo.com.tw 參考文獻: Wu, C.C., Hwang, C.R., Liu, T.J., There is no need for nasogastric decompression after partial gastrectomy with extensive lymphadenectomy (1994) Eur J Surg, 160, pp. 369-373; Hsu, S.D., Yu, J.C., Chen, T.W., Chou, S.J., Hsieh, H.F., Chan, D.C., Role of Nasogastric Tube Insertion after Gastrectomy (2007) Chir Gastroenterol, 23, pp. 303-306; Yoo, C.H., Son, B.H., Han, W.K., Pae, W.K., Nasogastric decompression is not necessary in operations for gastric cancer: Prospective randomised trial (2002) Eur J Surg, 168, pp. 379-383; Lee, J.H., Hyung, W.J., Noh, S.H., Comparison of gastric cancer surgery with versus without nasogastric decompression (2002) Yonsei Med J, 43, pp. 451-456; Doglietto, G.B., Papa, V., Tortorelli, A.P., Bossola, M., Covino, M., Pacelli, F., Nasojejunal tube placement after total gastrectomy: A multicenter prospective randomized trial (2004) Arch Surg, 139, pp. 1309-1313. , discussion 1313; Chan, D.C., Fan, Y.M., Lin, C.K., Chen, C.J., Chen, C.Y., Chao, Y.C., Roux-en-Y reconstruction after distal gastrectomy to reduce enterogastric reflux and Helicobacter pylori infection (2007) J Gastrointest Surg, 11, pp. 1732-1740; Horan, T.C., Gaynes, R.P., Martone, W.J., Jarvis, W.R., Emori, T.G., CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections (1992) Infect Control Hosp Epidemiol, 13, pp. 606-608; Braga, M., Costantini, E., di Francesco, A., Gianotti, L., Baccari, P., di Carlo, V., Impact of thymopentin on the incidence and severity of postoperative infection: A randomized controlled trial (1994) Br J Surg, 81, pp. 205-208; Fujita, T., Katai, H., Morita, S., Saka, M., Fukagawa, T., Sano, T., Short-term outcomes of Roux-en-Y stapled anastomosis after distal gastrectomy for gastric adenocarcinoma (2010) J Gastrointest Surg, 14, pp. 289-294; Nathan, B.N., Pain, J.A., Nasogastric suction after elective abdominal surgery: A randomised study (1991) Ann R Coll Surg Engl, 73, pp. 291-294; Lei, W.Z., Zhao, G.P., Cheng, Z., Li, K., Zhou, Z.G., Gastrointestinal decompression after excision and anastomosis of lower digestive tract (2004) World J Gastroenterol, 10, pp. 1998-2001; Guyton, A.C., (2000) Textbook of Medical Physiology, , 10th ed. Philadelphia: W.B. Saunders, Inc; Hoffmann, S., Koller, M., Plaul, U., Stinner, B., Gerdes, B., Lorenz, W., Rothmund, M., Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: A prospective, randomized trial comparing patients' tube-related inconvenience (2001) Langenbecks Arch Surg, 386, pp. 402-409; Manning, B.J., Winter, D.C., McGreal, G., Kirwan, W.O., Redmond, H.P., Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy (2001) Surgery, 130, pp. 788-791; Cheatham, M.L., Chapman, W.C., Key, S.P., Sawyers, J.L., A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy (1995) Ann Surg, pp. 469-476. , discussion 476-478; Wolff, B.G., Pembeton, J.H., van Heerden, J.A., Beart, R.W., Nivatvongs, S., Devine, R.M., Dozois, R.R., Ilstrup, D.M., Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial (1989) Ann Surg, 209, pp. 670-673. , discussion 670-673; Trepanier, C.A., Isabel, L., Perioperative gastric aspiration increases postoperative nausea and vomiting in outpatients (1993) Can J Anesthesia, 40, pp. 325-328

PY - 2012

Y1 - 2012

N2 - AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery. METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (B II) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression. RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet wzas significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with B II reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in B II group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the B II group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the B II group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001). CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy. © 2012 Baishideng. All rights reserved.

AB - AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery. METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (B II) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression. RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet wzas significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with B II reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in B II group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the B II group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the B II group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001). CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy. © 2012 Baishideng. All rights reserved.

KW - Billroth II gastrojejunostomy

KW - Gastric cancer

KW - Nasogastric decompression

KW - Radical distal gastrectomy

KW - Roux-en-Y gastrojejunostomy

KW - adult

KW - aged

KW - anastomosis leakage

KW - article

KW - cancer surgery

KW - controlled study

KW - disease severity

KW - female

KW - gastrectomy

KW - gastrectomy Billroth II

KW - human

KW - length of stay

KW - major clinical study

KW - male

KW - nasogastric decompression

KW - pneumonia

KW - postoperative period

KW - retrospective study

KW - Roux Y anastomosis

KW - sore throat

KW - stomach cancer

KW - stomach disease

KW - gastroenterostomy

KW - methodology

KW - middle aged

KW - postoperative complication

KW - stomach

KW - stomach tumor

KW - treatment outcome

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Anastomosis, Roux-en-Y

KW - Female

KW - Gastrectomy

KW - Gastroenterostomy

KW - Humans

KW - Male

KW - Middle Aged

KW - Postoperative Complications

KW - Postoperative Period

KW - Retrospective Studies

KW - Stomach

KW - Stomach Neoplasms

KW - Treatment Outcome

U2 - 10.3748/wjg.v18.i3.251

DO - 10.3748/wjg.v18.i3.251

M3 - Article

VL - 18

SP - 251

EP - 256

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 3

ER -