Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Am J Surg. 2019 Nov;218(5):940-945. doi: 10.1016/j.amjsurg.2019.03.009. Epub 2019 Mar 13.
The aim of this study is to report the short and long-term results of a cohort of patients who underwent Billroth II (BII) Distal Gastrectomy (DG) for gastric cancer (GC), in a tertiary referral Western center.
From January 2005 to December 2015, a prospective observational study was conducted in candidate patients to elective gastrectomy for cancer.
Among 514 patients observed with GC, a series of 258 patients underwent BII DG for middle/lower third GC. Postoperative mortality and complication rates were 1.5% and 12.4% respectively. The overall and disease-free 5-year survival rates were 78% and 69%, respectively. Young age, lymph nodes retrieved, radicality of resection, and early tumor stages were independent positive prognostic factors at multivariate analysis for 5-year overall survival. Abdominal complications and advanced tumor stages negatively influenced 5-year disease-free survival at multivariate analysis.
BII provides excellent results in terms of short and long-term prognosis and should be regarded as an acceptable reconstructive option following DG for GC.
本研究旨在报告在一家三级转诊西方中心，接受 Billroth II（BII）远端胃切除术（DG）治疗胃癌（GC）的患者队列的短期和长期结果。
从 2005 年 1 月至 2015 年 12 月，对候选患者进行了一项前瞻性观察性研究，以进行癌症的选择性胃切除术。
在观察到的 514 例 GC 患者中，一系列 258 例患者接受了中/下三分之一 GC 的 BII DG。术后死亡率和并发症发生率分别为 1.5%和 12.4%。总体和无病 5 年生存率分别为 78%和 69%。在多变量分析中，年轻、淋巴结检出、切除的根治性和早期肿瘤分期是 5 年总生存率的独立阳性预后因素。在多变量分析中，腹部并发症和晚期肿瘤分期对 5 年无病生存率有负面影响。
BII 在短期和长期预后方面提供了优异的结果，应被视为 GC 后 DG 的一种可接受的重建选择。
