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

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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. © 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

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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

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, 18(3), 251-256. https://doi.org/10.3748/wjg.v18.i3.251