Billroth-II with Braun versus Roux-en-Y reconstruction in totally laparoscopic distal gastrectomy for gastric cancer

Introduction
Totally laparoscopic distal gastrectomy (TLDG) has been increasingly adopted for the treatment of gastric cancer. Both Billroth-II with Braun (B-IIB) reconstruction and Roux-en-Y (R-Y) reconstruction are commonly performed in TLDG; however, which of these reconstruction techniques is better remains unclear. Aim: To compare the efficacy of B-IIB reconstruction and R-Y reconstruction in TLDG for gastric cancer.

Material and methods
A total of 105 gastric cancer patients who underwent TLDG with B-IIB or R-Y reconstruction were reviewed from January 2019 to July 2020. Clinicopathological characteristics and perioperative data of the B-IIB and R-Y groups were compared.

Results
Clinicopathological characteristics were not significantly different between the B-IIB and R-Y groups. The average total operative time for the R-Y group (161.9 ±20.7 min) was significantly longer than that for the B-IIB group (141.9 ±16.7 min). The average anastomosis time for the R-Y group (25.5 ±4.1 min) was also significantly longer than that for the B-IIB group (18.9 ±3.3 min). Blood loss volume, number of retrieved lymph nodes, time to first flatus, average length of postoperative hospital stay, inflammatory parameters and postoperative complications did not differ between the two groups.

Conclusions
Both B-IIB reconstruction and R-Y reconstruction are safe and effective in TLDG. B-IIB reconstruction is easier and faster to perform than R-Y reconstruction in TLDG.