Comparison of Quality of Life and Nutritional Status of Between Roux-en-Y and Billroth-I Reconstruction After Distal Gastrectomy: A Systematic Review and Meta-Analysis

• Published in: Nutrition and cancer Vol. 72; no. 5; pp. 849 - 857
• Main Authors: Du, Nannan, Chen, Manman, Shen, Zefeng, Li, Shengnan, Chen, Ping, Khadaroo, Parishit A., Mao, Danyi, Gu, Lihu
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03.07.2020; Taylor & Francis Ltd
• Subjects: Albumins; Anastomosis, Roux-en-Y - adverse effects; Anastomosis, Roux-en-Y - methods; Cholesterol; Constipation; Dyspnea; Gastrectomy; Gastrectomy - adverse effects; Gastrectomy - methods; Gastroenterostomy - adverse effects; Gastroenterostomy - methods; Hemoglobin; Humans; Indicators; Meta-analysis; Nutritional Status; Pain; Quality of Life; Randomized Controlled Trials as Topic; Reconstruction; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - methods; Respiration; Short term; Stomach Neoplasms - metabolism; Stomach Neoplasms - psychology; Stomach Neoplasms - surgery; Treatment Outcome
• ISSN: 0163-5581; 1532-7914
• DOI: 10.1080/01635581.2019.1656262

Background: This paper purports to use a meta-analysis to compare the postoperative quality of life (QoL) and nutritional status of between Roux-en-Y (R-Y) and Billroth-I (B-I) reconstruction after distal gastrectomy. Methods: For this study, the following databases were searched for articles published from inception until December 2018: PubMed, Web of Science, EBSCO, and Cochrane library. Results: A total of 13 eligible studies, covering 3645 patients, were selected for a meta-analysis. The analysis showed that compared with B-I group in term of short-term outcomes, patients undergoing R-Y reconstruction did not only have significantly better physiological function (P = 0.02), but had significantly less pain (P = 0.04). In the long-term outcomes, the dyspnea and constipation in the B-I group were worse than that in the R-Y group (P = 0.004; P = 0.04, respectively). Patients in the B-I group had higher cholesterol than those in the R-Y group at 5 years postoperatively (P = 0.003). There were no significant differences in termof other nutritional indicators including total protein, cholesterol, albumin, hemoglobin and weight in short-term outcomes. Conclusions: The final conclusion was that R-Y may be superior to the B-I reconstruction in some aspects of QoL. Besides, R-Y reconstruction could reduce the patient's cholesterol level for a long time. For the short-term outcomes, there were no significant differences in other common nutritional indicators.