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Postoperative Body Mass Index Changes in Gastric Cancer Patients According to Reconstruction Type: Effectiveness of Long Jejunal Bypass on Weight Loss in Obese Patients After Distal Gastrectomy

Overview
Journal Indian J Surg
Specialty General Surgery
Date 2014 Sep 2
PMID 25177114
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Abstract

The aim of this study was to investigate and compare the change of body mass index (BMI) in patients after gastrectomy for cancer according to the type of reconstruction. BMI was followed in 260 patients who had undergone curative surgery for gastric cancer from March 2003 to December 2009. The procedures were Billroth I in 63 patients, Billroth II in 52 patients, Roux-en-Y in 54 patients, long Roux-en-Y (bypassed proximal jejunum over 100 cm) in 47 patients, and total gastrectomy in 44 patients. BMI reduction was greatest in the total gastrectomy group at postoperative 6 months, 1 year, and 2 years. Postoperative 3-year BMI reduction was greatest in the long Roux-en-Y group. BMI reductions of the total gastrectomy and long Roux-en-Y groups were similar during the follow-up period. Among the subtotal gastrectomy groups, BMI reduction was greatest in the long Roux-en-Y group, and there was statistical significance in comparing with Billroth I and II groups, but no statistical difference with the Roux-en-Y group. Given the limitations of patient number and follow-up period, it can be concluded that obese patients with gastric cancer not requiring total gastrectomy may benefit from long Roux-en-Y reconstruction with adequate BMI reduction and accompanying health improvement.

References
1.
Ambrogi M, Volpe S, Tamanini C . Ghrelin: central and peripheral effects of a novel peptydil hormone. Med Sci Monit. 2003; 9(9):RA217-24. View

2.
Oh S . Obesity and metabolic syndrome in Korea. Diabetes Metab J. 2012; 35(6):561-6. PMC: 3253964. DOI: 10.4093/dmj.2011.35.6.561. View

3.
Castaneda T, Tong J, Datta R, Culler M, Tschop M . Ghrelin in the regulation of body weight and metabolism. Front Neuroendocrinol. 2009; 31(1):44-60. DOI: 10.1016/j.yfrne.2009.10.008. View

4.
Choban P, Flancbaum L . The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002; 12(4):540-5. DOI: 10.1381/096089202762252316. View

5.
Bruder , Freeman . Lengthening the Roux-Y Limb Increases Weight Loss after Gastric Bypass: a preliminary report. Obes Surg. 1991; 1(1):73-77. DOI: 10.1381/096089291765561501. View