Supplementary Material for: Long-Limb Roux-en-Y Reconstruction for Glycemic Control in Patients with Gastric Cancer and Type 2 Diabetes: 1-Year Outcomes of Oncometabolic Surgery

Background: Long-limb Roux-en-Y (LLRY) reconstruction has recently been implemented as an oncometabolic surgery to improve glycemic control following surgery for gastric cancer (GC); however, data on its feasibility are insufficient. We investigated the 1-year outcomes of LLRY reconstruction for glycemic control in patients with T2D. Methods: We reviewed the records of 15 patients with GC and T2D who underwent LLRY reconstruction after gastrectomy, with biliopancreatic and Roux limb lengths of 130–250 cm, to improve postoperative glycemic control. The primary outcome was the T2D remission (glycated hemoglobin <6.5% without antidiabetic medication) rate at 12 months postoperatively. The diabetes prediction (DP) score and Korean nationwide average T2D remission rates following GC surgery were compared. Results: The mean patient age was 66.5 years (standard deviation [SD] 9.6), mean body mass index was 26.4 kg/m2 (SD 4.4), and mean glycated hemoglobin level was 7.7% (SD 1.5). The overall T2D remission rate was 46.7%. The postoperative T2D remission rate was 12.9% higher than the DP score estimate (33.8%) and 25.7% higher than the Korean national average rate (21%) of T2D remission following GC surgery. Conclusion: Our results show that LLRY reconstruction after gastrectomy is an effective oncometabolic surgery for treating T2D and GC.