{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T23:41:56Z","timestamp":1776814916243,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,28]],"date-time":"2016-04-28T00:00:00Z","timestamp":1461801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim:<\/jats:title><jats:p>No study has compared the incidence of postoperative anemia between two reconstruction methods, Billroth\u2010I (B\u2010I) and Roux\u2010en\u2010Y (R\u2010Y) reconstructions, after distal gastrectomy for gastric cancer (GC). In this study, we wished to examine the postoperative decrease in hemoglobin (Hb) as an indicator of iron\u2010deficiency anemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>We investigated a total of 119 consecutive patients who underwent distal gastrectomy with B\u2010I or R\u2010Y reconstruction for Stage I GC between 2006 and 2012. We retrospectively assessed the clinical data, including Hb results, of the first 2\u2009years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Compared with B\u2010I reconstruction, R\u2010Y reconstruction was performed more frequently in older patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.017), and it was associated with a longer surgical duration (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), a larger amount of blood loss (<jats:italic>P<\/jats:italic>\u2009=\u20090.031), a higher incidence of stasis (<jats:italic>P<\/jats:italic>\u2009=\u20090.044), and a greater decrease in Hb for the first 2\u2009years after surgery. Univariate and multivariate analyses identified that R\u2010Y reconstruction was the only risk factor (<jats:italic>P<\/jats:italic>\u2009=\u20090.0487; odds ratio\u2009=\u20092.755; 95% confidence interval\u2009=\u20091.01\u20137.91) for a decrease in Hb, independent of age, tumor location, postoperative complications, and other factors. In addition, an age\u2009\u2265\u200975 was identified as an independent risk factor for a decrease in Hb, particularly for patients underwent R\u2010Y reconstruction (<jats:italic>P<\/jats:italic>\u2009=\u20090.033; odds ratio\u2009=\u20096.99; 95% confidence interval\u2009=\u20091.15\u201368.3) according to the multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Billroth\u2010I reconstruction might be preferable for the purpose of preventing a decrease in Hb in stage I GC patients, particularly in older patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13225","type":"journal-article","created":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T07:30:49Z","timestamp":1447745449000},"page":"959-964","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Reconstruction method as an independent risk factor for the postoperative decrease in hemoglobin in stage I gastric cancer"],"prefix":"10.1111","volume":"31","author":[{"given":"Taisuke","family":"Imamura","sequence":"first","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhei","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Kosuga","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuma","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotaka","family":"Konishi","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Shiozaki","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eigo","family":"Otsuji","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine  Kamigyo\u2010ku Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60617-6"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1953.01260040469018"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.11.1303"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529609094727"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6918(04)00122-2"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195904000-00013"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31827eebc1"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(67)90179-9"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-009-3964-2"},{"key":"e_1_2_6_12_1","first-page":"1469","article-title":"Billroth I versus Billroth II versus Roux\u2010en\u2010Y after subtotal gastrectomy. 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