scholarly journals Gastric cancer surgery: Billroth I or Billroth II for distal gastrectomy?

BMC Cancer ◽  
2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Birendra K Sah ◽  
Ming-Min Chen ◽  
Min Yan ◽  
Zheng-Gang Zhu
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Cancer Surgery ◽  
Billroth Ii ◽  
Gastric Cancer Surgery ◽  
Billroth I

scholarly journals Operation on Billroth-I in gastric cancer surgery: the evolution of views

2017 ◽  
Vol 8 (3) ◽  
pp. 151-157
Author(s):  
Temuri Sh Morgoshiia
Keyword(s):  
Gastric Cancer ◽  
Digestive Tract ◽  
Complete Removal ◽  
Cancer Surgery ◽  
Long Term Results ◽  
Resected Stomach ◽  
Continuous Increase ◽  
Gastric Cancer Surgery ◽  
Billroth I ◽  
Number Of Patients

In recent years almost all over the world, there is a decrease in the incidence of gastric cancer. Despite that carcinoma of the stomach annually affects on our planet about 1 million people. The prevalence of distal gastric cancer has a tendency to decrease, while the frequency of proximal cancer increases slightly. Early gastric cancer is only 10% of all new cases, and in 64,2% of patients are diagnosed at stages III-IV disease. Over the last 35 years, there has been substantial progress in the diagnosis and treatment of gastric cancer. Surgery that involves complete removal of the tumor remains the only method which gives hope for cure of the patient, despite the significant number of combined and complex treatment methods of this disease. However, many provisions of this concept have changed drastically. After surgery Billroth-I much less frequently and with less severity (than after resection Billroth-II) develops duodenogastric reflux in the absence of duodenostasis and adequate patency of the digestive tract. It is the reflux of bile and pancreatic juice plays an important role in the occurrence of cancer of the stomach stump. The basic cause of cancer is the development of atrophic gastritis as a consequence of denervation of the authority and the reflux of bile into the resected stomach. The choice of the method of restoring the integrity of digestive tract after distal gastrectomy is a topical problem, given the continuous increase in the number of patients undergoing this operation. In the review of literature shows that intervention in the modification of the Billroth-I does not increase the number of postoperative complications, no differences in long-term results of surgical treatment of gastric cancer for two methods of restoring the continuity of the digestive tract after distal resection.

Billroth II reconstruction in gastric cancer surgery: A good option for Western patients

2019 ◽  
Vol 218 (5) ◽  
pp. 940-945 ◽  
Author(s):  
Fausto Rosa ◽  
Giuseppe Quero ◽  
Claudio Fiorillo ◽  
Giovanni Battista Doglietto ◽  
Sergio Alfieri
Keyword(s):  
Gastric Cancer ◽  
Cancer Surgery ◽  
Good Option ◽  
Billroth Ii ◽  
Gastric Cancer Surgery ◽  
Billroth Ii Reconstruction

A randomized phase III trial to determine the efficacy of postoperative antimicrobial prophylaxis in gastric cancer surgery (OGSG0501)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15576-e15576
Author(s):  
K. Inoue ◽  
H. Imamura ◽  
Y. Kimura ◽  
K. Fujitani ◽  
Y. Miyake ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Distal Gastrectomy ◽  
Antimicrobial Prophylaxis ◽  
Cancer Surgery ◽  
Phase Iii ◽  
Site Infection ◽  
Phase Iii Trial ◽  
Gastric Cancer Surgery

e15576 Background: In Japan, antimicrobial prophylaxis (AMP) is typically administered for 3 to 4 days postoperatively in gastric cancer surgery. This far exceeds the recommended 24h or less laid out by the Centers for Disease Control (CDC) guidelines for the prevention of surgical-site infections, after a clean-contaminated operation. Methods: A multicenter randomized phase III trial was designed to evaluate the effect of postoperative AMP in gastric cancer surgery. Patients (pts) were required to have histologically proven gastric cancer which was curable by distal gastrectomy, be classifiable as ASA 1 or 2, and have adequate organ function. Pts were randomized to: (A) perioperative AMP (cefazolin 1g, at <30min before incision, every 3h intraoperative supplements) plus postoperative AMP (cefazolin 1g, twice daily for 2 postoperative days) or (B) perioperative AMP alone. Pts were stratified by institution and ASA. The primary endpoint was the incidence of surgical site infection (SSI). With 171 pts per arm, this study had 80% power to demonstrate non-inferiority with 5% margin of peri-AMP alone and 0.05 1-sided alpha. Results: 355 patients were recruited (A: 179, B: 176) in 7 centers between June 2005 and December 2007. The surgical-site infection rate was 9.0 percent (16 of 178) for peri-/post AMP and 4.5 percent (8 of 176) for peri-AMP alone, with no significant differences (Fisher's exact test: P=0.14, RR=1.98 [95%CI, 0.89–4.44]), but showing a significant non-inferiority (P<0.001). The remote site infection rate was 3.4 percent (6 of 178) for peri-/post AMP and 5.1 percent (9 of 175) for peri-AMP alone, with no significant differences (P=0.44, RR=0.66 [95%CI, 0.25- 1.70]). Conclusions: This multicenter randomized phase III trial confirms that postoperative AMP is unnecessary in patients undergoing distal gastrectomy for gastric cancer. No significant financial relationships to disclose.

scholarly journals Clinicopathologic features of remnant gastric cancer after curative distal gastrectomy according to previous reconstruction method: a retrospective cohort study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yong-Eun Park ◽  
Sang-Woon Kim
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Reconstruction Method ◽  
Remnant Gastric Cancer ◽  
Billroth Ii ◽  
Billroth I ◽  
Billroth I Reconstruction ◽  
Anastomosis Site ◽  
Billroth Ii Reconstruction ◽  
The Mean

Abstract Background Survival rate of patients treated for gastric cancer has increased due to early detection and improvements of surgical technique and chemotherapy. Increase in survival rate has led to an increase in the risk for remnant gastric cancer (RGC). The purpose of this study was to investigate clinicopathologic features of RGC according to previous reconstruction method and factors affecting the interval from previous curative distal gastrectomy for gastric cancer to RGC occurrence. Methods Medical records of patients diagnosed with RGC at Yeungnam University Medical Center from January 2000 to December 2017 who had a history of distal gastrectomy with D2 LN dissection due to gastric cancer were reviewed retrospectively. Results Forty-eight patients were enrolled in this study. The mean interval of 48 RGC patients was 105.6 months (8.8 years). RGC after Billroth II reconstruction recurred more often at anastomosis site than RGC after Billroth I reconstruction (p = 0.001). The mean interval of RGC after Billroth I reconstruction was 67 months, shorter than 119 months of RGC after Billroth II reconstruction (p = 0.003). On the contrary, interval showed no difference according to stage of previous gastric cancer, remnant gastric cancer, or sex (p = 0.810, 0.145, and 0.372, respectively). Conclusions RGC after Billroth I reconstruction tends to arise earlier at non-anastomosis site than RGC after Billroth II. Therefore, we should examine non-anastomosis site carefully from the beginning of surveillance after gastric cancer surgery with Billroth I reconstruction for better outcome.

scholarly journals Nutrition update in gastric cancer surgery

2020 ◽  
Vol 4 (4) ◽  
pp. 360-368 ◽  
Author(s):  
Takeshi Kubota ◽  
Katsutoshi Shoda ◽  
Hirotaka Konishi ◽  
Kazuma Okamoto ◽  
Eigo Otsuji
Keyword(s):  
Gastric Cancer ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery

scholarly journals Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033267
Author(s):  
Dengfeng Wang ◽  
Yang Yu ◽  
Pengxian Tao ◽  
Dan Wang ◽  
Yajing Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Evaluation Method ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Published Data ◽  
Gastric Cancer Surgery ◽  
Positive Prevention

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562

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