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The uncut Roux-en-Y with jejunal pouch: a new reconstruction technique for total gastrectomy.
Surgery. 2007 Jul; 142(1):33-9.S

Abstract

BACKGROUND

Roux Stasis Syndrome is a well-known complication after Roux-en-Y reconstruction. It has been hypothesized that reconstruction with an uncut Roux limb and jejunal pouch after total gastrectomy would preserve unidirectional intestinal myoelectrical activity, improve postoperative weight gain and nutritional parameters, and diminish Roux Stasis Syndrome in canines.

METHODS

A total gastrectomy was performed, and 2 methods were used for reconstruction: Roux-en-Y esophagojejunostomy (RY) was performed on 5 canines (control), and the uncut Roux-en-Y with a jejunal pouch (URYJP) was performed on 5 other canines (experimental). The canines were monitored for 10 weeks postoperatively. Serial weight and nutritional parameters were measured. Emptying profiles and motility studies were performed in the fasting and postprandial states.

RESULTS

Ten weeks after operation, the URYJP group had significantly improved nutritional parameters, including weight, total protein, albumin, hemoglobin, serum total iron binding capacity, and serum IgA, IgG, and IgM. The emptying times for both groups were similar, with an increase of disordered propagation of the jejunal pacesetter potential in the RY group. The aboral propagation occurred more frequently in the URYJP group during fasting and after feeding (98% +/- 1% vs 39% +/- 16%; P = .02, and 99% +/- 1% vs 43% +/- 18%; P = .03). The sites of luminal occlusions were intact in the URYJP group at 10 weeks.

CONCLUSIONS

The combination of jejunal pouch and uncut Roux limb improved overall nutritional parameters when compared with the traditional Roux-en-Y, while preserving aboral propagation of jejunal pacesetter potentials.

Authors+Show Affiliations

Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA. kchaiyas@msn.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17629998

Citation

Chaiyasate, Kongkrit, et al. "The Uncut Roux-en-Y With Jejunal Pouch: a New Reconstruction Technique for Total Gastrectomy." Surgery, vol. 142, no. 1, 2007, pp. 33-9.
Chaiyasate K, Jacobs M, Brooks SE, et al. The uncut Roux-en-Y with jejunal pouch: a new reconstruction technique for total gastrectomy. Surgery. 2007;142(1):33-9.
Chaiyasate, K., Jacobs, M., Brooks, S. E., del Rosario, G., Andrus, L., Kestenberg, W., & Mittal, V. (2007). The uncut Roux-en-Y with jejunal pouch: a new reconstruction technique for total gastrectomy. Surgery, 142(1), 33-9.
Chaiyasate K, et al. The Uncut Roux-en-Y With Jejunal Pouch: a New Reconstruction Technique for Total Gastrectomy. Surgery. 2007;142(1):33-9. PubMed PMID: 17629998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The uncut Roux-en-Y with jejunal pouch: a new reconstruction technique for total gastrectomy. AU - Chaiyasate,Kongkrit, AU - Jacobs,Michael, AU - Brooks,Steven E, AU - del Rosario,Gelen, AU - Andrus,Lee, AU - Kestenberg,William, AU - Mittal,Vijay, PY - 2006/09/06/received PY - 2007/03/01/revised PY - 2007/03/03/accepted PY - 2007/7/17/pubmed PY - 2007/8/22/medline PY - 2007/7/17/entrez SP - 33 EP - 9 JF - Surgery JO - Surgery VL - 142 IS - 1 N2 - BACKGROUND: Roux Stasis Syndrome is a well-known complication after Roux-en-Y reconstruction. It has been hypothesized that reconstruction with an uncut Roux limb and jejunal pouch after total gastrectomy would preserve unidirectional intestinal myoelectrical activity, improve postoperative weight gain and nutritional parameters, and diminish Roux Stasis Syndrome in canines. METHODS: A total gastrectomy was performed, and 2 methods were used for reconstruction: Roux-en-Y esophagojejunostomy (RY) was performed on 5 canines (control), and the uncut Roux-en-Y with a jejunal pouch (URYJP) was performed on 5 other canines (experimental). The canines were monitored for 10 weeks postoperatively. Serial weight and nutritional parameters were measured. Emptying profiles and motility studies were performed in the fasting and postprandial states. RESULTS: Ten weeks after operation, the URYJP group had significantly improved nutritional parameters, including weight, total protein, albumin, hemoglobin, serum total iron binding capacity, and serum IgA, IgG, and IgM. The emptying times for both groups were similar, with an increase of disordered propagation of the jejunal pacesetter potential in the RY group. The aboral propagation occurred more frequently in the URYJP group during fasting and after feeding (98% +/- 1% vs 39% +/- 16%; P = .02, and 99% +/- 1% vs 43% +/- 18%; P = .03). The sites of luminal occlusions were intact in the URYJP group at 10 weeks. CONCLUSIONS: The combination of jejunal pouch and uncut Roux limb improved overall nutritional parameters when compared with the traditional Roux-en-Y, while preserving aboral propagation of jejunal pacesetter potentials. SN - 0039-6060 UR - https://www.unboundmedicine.com/medline/citation/17629998/The_uncut_Roux_en_Y_with_jejunal_pouch:_a_new_reconstruction_technique_for_total_gastrectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(07)00216-4 DB - PRIME DP - Unbound Medicine ER -