Multicenter results of long-limb bypass reconstruction after gastrectomy in patients with gastric cancer and type II diabetes

Jong Han Kim, Yeon Ju Huh, Susan Park, Young Suk Park, Do Joong Park, Jin Won Kwon, Joo Ho Lee, Yoon Seok Heo, Seung Ho Choi

Research output: Contribution to journalArticle

Abstract

Background/Objective: The number of gastric cancer and type II diabetes mellitus is increasing in Korea. Metabolic surgery could be extended to gastric cancer patients with type II diabetes, especially those who are expected to achieve long-term survival. This study aimed to investigate change of diabetic status in patients undergoing long-limb Roux-en-Y bypass reconstruction compared with conventional Billroth II after curative gastrectomy. In total, 130 patients from five university hospital centers underwent long-limb Roux-en Y reconstruction after radical distal gastrectomy. Methods: In the long-limb group, the length of biliopancreatic limbs was more than 80 cm, and the length of the Roux limb was more than 80 cm. The control group comprised 96 patients who underwent conventional Billroth II reconstruction after distal gastrectomy. Follow-up data at three, six, nine, and 12 months were compared between the two groups. Results: Fasting blood sugar (FBS) and hemoglobin (Hb) A1c levels decreased more significantly in the long-limb Roux-en-Y group (FBS: 28.8 mg/dL; HbA1c: 0.72%). However, decreases in body mass index, albumin, and hemoglobin did not differ significantly between the two groups. Diabetes control significantly improved in the long-limb group. In multivariate analysis, long-limb bypass reconstruction was the significant factor for glycemic outcomes. Conclusion: Roux-en-Y bypass with increased length of limbs after gastrectomy shows a favorable glycemic control for gastric cancer patients with type II diabetes without nutritional deficit and anemia. To obtain future perspectives, large-scale prospective studies with long-term outcomes are needed.

Original languageEnglish
Pages (from-to)297-303
Number of pages7
JournalAsian Journal of Surgery
Volume43
Issue number1
DOIs
StatePublished - Jan 2020

Fingerprint

Gastrectomy
Type 2 Diabetes Mellitus
Stomach Neoplasms
Extremities
Gastroenterostomy
Blood Glucose
Fasting
Hemoglobins
Bariatric Surgery
Korea
Anemia
Albumins
Body Mass Index
Multivariate Analysis
Prospective Studies
Control Groups
Survival

Keywords

  • Gastric cancer
  • Long limb Roux-en Y
  • Type II DM

Cite this

Kim, Jong Han ; Huh, Yeon Ju ; Park, Susan ; Park, Young Suk ; Park, Do Joong ; Kwon, Jin Won ; Lee, Joo Ho ; Heo, Yoon Seok ; Choi, Seung Ho. / Multicenter results of long-limb bypass reconstruction after gastrectomy in patients with gastric cancer and type II diabetes. In: Asian Journal of Surgery. 2020 ; Vol. 43, No. 1. pp. 297-303.
@article{9a61b186a05b4533a531cacd1003f766,
title = "Multicenter results of long-limb bypass reconstruction after gastrectomy in patients with gastric cancer and type II diabetes",
abstract = "Background/Objective: The number of gastric cancer and type II diabetes mellitus is increasing in Korea. Metabolic surgery could be extended to gastric cancer patients with type II diabetes, especially those who are expected to achieve long-term survival. This study aimed to investigate change of diabetic status in patients undergoing long-limb Roux-en-Y bypass reconstruction compared with conventional Billroth II after curative gastrectomy. In total, 130 patients from five university hospital centers underwent long-limb Roux-en Y reconstruction after radical distal gastrectomy. Methods: In the long-limb group, the length of biliopancreatic limbs was more than 80 cm, and the length of the Roux limb was more than 80 cm. The control group comprised 96 patients who underwent conventional Billroth II reconstruction after distal gastrectomy. Follow-up data at three, six, nine, and 12 months were compared between the two groups. Results: Fasting blood sugar (FBS) and hemoglobin (Hb) A1c levels decreased more significantly in the long-limb Roux-en-Y group (FBS: 28.8 mg/dL; HbA1c: 0.72{\%}). However, decreases in body mass index, albumin, and hemoglobin did not differ significantly between the two groups. Diabetes control significantly improved in the long-limb group. In multivariate analysis, long-limb bypass reconstruction was the significant factor for glycemic outcomes. Conclusion: Roux-en-Y bypass with increased length of limbs after gastrectomy shows a favorable glycemic control for gastric cancer patients with type II diabetes without nutritional deficit and anemia. To obtain future perspectives, large-scale prospective studies with long-term outcomes are needed.",
keywords = "Gastric cancer, Long limb Roux-en Y, Type II DM",
author = "Kim, {Jong Han} and Huh, {Yeon Ju} and Susan Park and Park, {Young Suk} and Park, {Do Joong} and Kwon, {Jin Won} and Lee, {Joo Ho} and Heo, {Yoon Seok} and Choi, {Seung Ho}",
year = "2020",
month = "1",
doi = "10.1016/j.asjsur.2019.03.018",
language = "English",
volume = "43",
pages = "297--303",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",
number = "1",

}

Multicenter results of long-limb bypass reconstruction after gastrectomy in patients with gastric cancer and type II diabetes. / Kim, Jong Han; Huh, Yeon Ju; Park, Susan; Park, Young Suk; Park, Do Joong; Kwon, Jin Won; Lee, Joo Ho; Heo, Yoon Seok; Choi, Seung Ho.

In: Asian Journal of Surgery, Vol. 43, No. 1, 01.2020, p. 297-303.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multicenter results of long-limb bypass reconstruction after gastrectomy in patients with gastric cancer and type II diabetes

AU - Kim, Jong Han

AU - Huh, Yeon Ju

AU - Park, Susan

AU - Park, Young Suk

AU - Park, Do Joong

AU - Kwon, Jin Won

AU - Lee, Joo Ho

AU - Heo, Yoon Seok

AU - Choi, Seung Ho

PY - 2020/1

Y1 - 2020/1

N2 - Background/Objective: The number of gastric cancer and type II diabetes mellitus is increasing in Korea. Metabolic surgery could be extended to gastric cancer patients with type II diabetes, especially those who are expected to achieve long-term survival. This study aimed to investigate change of diabetic status in patients undergoing long-limb Roux-en-Y bypass reconstruction compared with conventional Billroth II after curative gastrectomy. In total, 130 patients from five university hospital centers underwent long-limb Roux-en Y reconstruction after radical distal gastrectomy. Methods: In the long-limb group, the length of biliopancreatic limbs was more than 80 cm, and the length of the Roux limb was more than 80 cm. The control group comprised 96 patients who underwent conventional Billroth II reconstruction after distal gastrectomy. Follow-up data at three, six, nine, and 12 months were compared between the two groups. Results: Fasting blood sugar (FBS) and hemoglobin (Hb) A1c levels decreased more significantly in the long-limb Roux-en-Y group (FBS: 28.8 mg/dL; HbA1c: 0.72%). However, decreases in body mass index, albumin, and hemoglobin did not differ significantly between the two groups. Diabetes control significantly improved in the long-limb group. In multivariate analysis, long-limb bypass reconstruction was the significant factor for glycemic outcomes. Conclusion: Roux-en-Y bypass with increased length of limbs after gastrectomy shows a favorable glycemic control for gastric cancer patients with type II diabetes without nutritional deficit and anemia. To obtain future perspectives, large-scale prospective studies with long-term outcomes are needed.

AB - Background/Objective: The number of gastric cancer and type II diabetes mellitus is increasing in Korea. Metabolic surgery could be extended to gastric cancer patients with type II diabetes, especially those who are expected to achieve long-term survival. This study aimed to investigate change of diabetic status in patients undergoing long-limb Roux-en-Y bypass reconstruction compared with conventional Billroth II after curative gastrectomy. In total, 130 patients from five university hospital centers underwent long-limb Roux-en Y reconstruction after radical distal gastrectomy. Methods: In the long-limb group, the length of biliopancreatic limbs was more than 80 cm, and the length of the Roux limb was more than 80 cm. The control group comprised 96 patients who underwent conventional Billroth II reconstruction after distal gastrectomy. Follow-up data at three, six, nine, and 12 months were compared between the two groups. Results: Fasting blood sugar (FBS) and hemoglobin (Hb) A1c levels decreased more significantly in the long-limb Roux-en-Y group (FBS: 28.8 mg/dL; HbA1c: 0.72%). However, decreases in body mass index, albumin, and hemoglobin did not differ significantly between the two groups. Diabetes control significantly improved in the long-limb group. In multivariate analysis, long-limb bypass reconstruction was the significant factor for glycemic outcomes. Conclusion: Roux-en-Y bypass with increased length of limbs after gastrectomy shows a favorable glycemic control for gastric cancer patients with type II diabetes without nutritional deficit and anemia. To obtain future perspectives, large-scale prospective studies with long-term outcomes are needed.

KW - Gastric cancer

KW - Long limb Roux-en Y

KW - Type II DM

UR - http://www.scopus.com/inward/record.url?scp=85065043027&partnerID=8YFLogxK

U2 - 10.1016/j.asjsur.2019.03.018

DO - 10.1016/j.asjsur.2019.03.018

M3 - Article

AN - SCOPUS:85065043027

VL - 43

SP - 297

EP - 303

JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

IS - 1

ER -