Influence of the Retrocolic Versus Antecolic Route for Alimentary Tract Reconstruction on Delayed Gastric Emptying After Pancreatoduodenectomy: A Multicenter, Noninferiority Randomized Controlled Trial
| العنوان: | Influence of the Retrocolic Versus Antecolic Route for Alimentary Tract Reconstruction on Delayed Gastric Emptying After Pancreatoduodenectomy: A Multicenter, Noninferiority Randomized Controlled Trial |
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| المؤلفون: | Hirofumi Fujita, Motofumi Tanaka, Takumi Fukumoto, Sachio Terai, Yoshihiro Kanbara, Keiichi Okano, Hironori Yamashita, Jun Ishida, Kimihiko Ueno, Kunihiro Nishimura, Sae Murakami, Tetsuo Ajiki, Ippei Matsumoto, Yoshihiko Kadowaki, Masahiro Kido, Sachiyo Shirakawa, Hirochika Toyama, Shinobu Tsuchida, Hiromi Maeda, Masato Fukuoka, Takuya Mizumoto, Shiro Takase, Hideyo Mukubo |
| المصدر: | Annals of surgery. 274(6) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Gastroparesis, Colon, law.invention, Pancreaticoduodenectomy, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, Japan, law, Medicine, Humans, Single-Blind Method, Prospective Studies, Aged, Gastric emptying, business.industry, Incidence (epidemiology), fungi, Background data, Absolute risk reduction, Nutritional status, Plastic Surgery Procedures, Confidence interval, Alimentary tract, Surgery, Pancreatic Neoplasms, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, business |
| الوصف: | Objective This study aimed to determine whether retrocolic alimentary tract reconstruction is noninferior to antecolic reconstruction in terms of DGE incidence after pancreatoduodenectomy (PD) and investigated patients' postoperative nutritional status. Summary of background data The influence of the route of alimentary tract reconstruction on DGE after PD is controversial. Methods Patients from 9 participating institutions scheduled for PD were randomly allocated to the retrocolic or antecolic reconstruction groups. The primary outcome was incidence of DGE, defined according to the 2007 version of the International Study Group for Pancreatic Surgery definition. Noninferiority would be indicated if the incidence of DGE in the retrocolic group did not exceed that in the antecolic group by a margin of 10%. Patients' postoperative nutrition data were compared as secondary outcomes. Results Total, 109 and 103 patients were allocated to the retrocolic and antecolic reconstruction group, respectively (n = 212). Baseline characteristics were similar between both groups. DGE occurred in 17 (15.6%) and 13 (12.6%) patients in the retrocolic and antecolic group, respectively (risk difference; 2.97%, 95% confidence interval; -6.3% to 12.6%, which exceeded the specified margin of 10%). There were no differences in the incidence of other postoperative complications and in the duration of hospitalization. Postoperative nutritional indices were similar between both groups. Conclusions This trial could not demonstrate the noninferiority of retrocolic to antecolic alimentary tract reconstruction in terms of DGE incidence. The alimentary tract should not be reconstructed via the retrocolic route after PD, to prevent DGE. |
| تدمد: | 1528-1140 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d6692f2f56a0b000e3f31edadf4011b9 https://pubmed.ncbi.nlm.nih.gov/32773628 |
| رقم الأكسشن: | edsair.doi.dedup.....d6692f2f56a0b000e3f31edadf4011b9 |
| قاعدة البيانات: | OpenAIRE |
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