BMI, Sex Linked to Roux Stasis Syndrome After Gastrectomy

M. Alexander Otto, PA, MMS

September 02, 2022

The study covered in this summary was published on as a preprint and has not yet been peer reviewed.

Key Takeaways

  • Male sex and having a BMI (BMI) indicating underweight or obesity are both independent risk factors for Roux stasis syndrome (RSS) following Roux-en-Y reconstruction after gastric cancer surgery.

  • A nomogram incorporating sex, BMI, nerve invasion, and smoking predicts RSS occurrence.

Why This Matters

  • Roux-en-Y reconstruction is common after distal gastrectomy, but 10% to 30% of patients develop RSS, gastrointestinal dysfunction that often comes with abdominal pain, vomiting, and nausea after eating.

  • The findings identify patients who need early intervention to reduce the onset of RSS. These interventions include prokinetic agents in the immediate postoperative period and prolonged nasogastric tube decompression.

Study Design

  • The team reviewed 220 patients who underwent distal gastrectomy with Roux-en-Y reconstruction from 2014 to 2021 at Peking University, China.

Key Results

  • Twenty patients (9.1%) developed RSS.

  • The incidence of RSS was higher in men (11.9% vs 3.9% for women) and higher among patients with BMI <18.5 kg/m2 (20%) as well >28.0 kg/m2 (29%), compared with 8% among patients with BMI between those figures.

  • On multivariate regression, each risk factor was associated with fourfold to fivefold higher odds of developing RSS.

  • Smoking and tumors with nerve invasion also increased the risk but not significantly.

  • A nomogram incorporating sex, BMI group, nerve invasion, and smoking predicted RSS (AUC, 0.71).

  • There was no significant difference in the incidence of RSS with laparoscopic vs open surgery.


  • The study was restrospective and was conducted at a single center.

  • Surgeons performed antecolic reconstructions with isoperistaltic anastomoses in all cases, so comparison with other approaches wasn’t possible.

  • The nomogram was not externally validated.


  • The work was supported by the National Natural Science Foundation of China and others.

  • The investigators have disclosed no relevant financial relationships.

This is a summary of a preprint research study, "Predictive Factors for Roux Stasis Syndrome After Distal Gastrectomy With Roux-en-Y Reconstruction in Gastric Cancer Patients: A Retrospective Comparative Cohort Study," led by Yan Meng of the Peking University Health Science Center, China, and provided to you by Medscape. The study has not been peer reviewed. The full text can be found at

M. Alexander Otto is a physician assistant with a master's degree in medical science. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape and is an MIT Knight Science Journalism fellow. Email:

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