A Retrospective Study Comparing Reconstruction Methods after Distal Gastrectomy for Gastric Cancer in Patients with Type 2 Diabetes Mellitus

Ito Ryota, Minamimura Keisuke, Isogawa Akihiro, Kono Yoshiharu, Mori Kazuhiko, Hirata Toru, Kobayashi Takashi, Kawasaki Seiji

doi:10.5833/jjgs.2019.0154

<p>Purpose: The recent treatment improvement and better long-term survival for patients with gastric cancer have made treatment for metabolic comorbidities such as diabetes mellitus more important. In this study, we examined the optimal reconstruction method after distal gastrectomy for gastric cancer patients with diabetes mellitus. Materials and Methods: Among 307 gastric cancer patients who underwent distal gastrectomy in our hospital from 2009 to 2018, 56 patients with type 2 diabetes mellitus were retrospectively investigated. A questionnaire survey for primary care doctors was also conducted. Changes of BMI and HbA1c at one year postoperatively and diabetes medication were examined. Result: Fourteen Billroth I, 5 Billroth II and 13 Roux-en-Y reconstructions were performed in the subjects. There were no significant differences in BMI and HbA1c between the three methods. Three Billroth I (22%), no Billroth II and eight Roux-en-Y cases (62%) reduced the dose of diabetes medication. Roux-en-Y cases succeeded in reducing medications more frequently than the other types (P=0.022). Four patients used insulin before the procedure and in two of the four insulin could be withdrawn. Both of these patients underwent Roux-en-Y reconstructions. Conclusion: In gastric cancer surgery, Roux-en-Y reconstruction was associated with improvement of diabetes, such as dose reduction of oral medications or withdrawal of insulin.</p>

A Retrospective Study Comparing Reconstruction Methods after Distal Gastrectomy for Gastric Cancer in Patients with Type 2 Diabetes Mellitus

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