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Billroth-II (gastrojejunostomy) is one of major option after gastrectomy for gastric cancer. The investigators hypothesized that isoperistaltic anastomosis lead to higher incidence of dumping syndrome but antiperistaltic (anisoperistaltic) anastomosis have relevance to gastric stasis or obstruction. The investigators will assess complications, dumping syndrome and quality of life between isoperistaltic and antiperistaltic after distal gastrectomy for gastric cancer.
Recently, laparoscopic approach has been a option for gastric cancer, especially early gastric cancer. There are growing interest in quality of life in addition to recurrence or survival. There are few report about peristalsis and no report for quality of life according to a direction of peristalsis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Isoperistaltic | Active Comparator | Same direction of peristalsis between stomach and jejunum, efferent loop of jejunum is located on the distal part of remnant stomach |
|
| Antiperistaltic | Experimental | Reverse direction of peristalsis between stomach and jejunum, efferent loop of jejunum is located on the proximal part of remnant stomach |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Isoperistaltic | Procedure | Same direction of peristalsis between stomach and jejunum, efferent loop of jejunum is located on the distal part of remnant stomach |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dumping syndrome | Using Sigstad's score | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| long-term complication | all kind of complication | from 1 month to 12 months |
| Total score of quality of life questionnaire | by EORTC questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Seung Wan Ryu, M.D., Ph.D. | Contact | 82-53-250-7322 | gsman@dsmc.or.kr |
| Name | Affiliation | Role |
|---|---|---|
| Seung Wan Ryu, M.D., Ph.D. | Keimyung University Dongsan Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Keimyung University Dongsan Medical Center | Recruiting | Daegu | 700-712 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23233009 | Result | Banerjee A, Ding Y, Mikami DJ, Needleman BJ. The role of dumping syndrome in weight loss after gastric bypass surgery. Surg Endosc. 2013 May;27(5):1573-8. doi: 10.1007/s00464-012-2629-1. Epub 2012 Dec 12. | |
| 12496544 | Result | Bergamaschi R, Arnaud JP, Marvik R, Myrvold HE. Laparoscopic antiperistaltic versus isoperistaltic gastrojejunostomy for palliation of gastric outlet obstruction in advanced cancer. Surg Laparosc Endosc Percutan Tech. 2002 Dec;12(6):393-7. doi: 10.1097/00129689-200212000-00002. |
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| ID | Term |
|---|---|
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000930 | Antidiarrheals |
| ID | Term |
|---|---|
| D005765 | Gastrointestinal Agents |
| D045506 | Therapeutic Uses |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
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| Antiperistaltic | Procedure | Reverse direction of peristalsis between stomach and jejunum, efferent loop of jejunum is located on the proximal part of remnant stomach |
|
| 12 months |
| Body weight change | for evaluate nutritional status | 12 months |
| Surgical complication | all kind of complication within 1 month | within 1 month |
| Gastritis | by endoscopic evaluation | 12 months |
| 20829078 | Result | Mine S, Sano T, Tsutsumi K, Murakami Y, Ehara K, Saka M, Hara K, Fukagawa T, Udagawa H, Katai H. Large-scale investigation into dumping syndrome after gastrectomy for gastric cancer. J Am Coll Surg. 2010 Nov;211(5):628-36. doi: 10.1016/j.jamcollsurg.2010.07.003. Epub 2010 Sep 15. |
| 8763175 | Result | Houghton AD, Liepins P, Clarke S, Mason R. Iso- or antiperistaltic anastomosis: does it matter? J R Coll Surg Edinb. 1996 Jun;41(3):148-51. |
| D004066 |
| Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |