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[Clinical study on the alimentary canal reconstruction of uncutted Roux-en-Y with jejunal pouch for total gastrectomy].
Zhonghua Wei Chang Wai Ke Za Zhi. 2008 Sep; 11(5):424-7.ZW

Abstract

OBJECTIVE

To investigate the efficacy of uncutted Roux-en-Y esophagojejunostomy with jejunal pouch (URYJP) after total gastrectomy.

METHODS

Total gastrectomy was performed on 168 patients of gastric cancer, and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch was performed on 69 patients(group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients(group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C). The alimentary tract reconstruction time, morbidity and mortality were compared. The 121 cases that survived for more than 1 year were analyzed for quality of life(QOL),including body weight, intake quantity, prognosis nutritional index (PNI), and Visick scores 6 and 12 months after the operations.

RESULTS

All the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found. It took (30+/-7) minutes to finish the reconstruction in group A, which was significantly shorter than that in group B [(57+/-6) minutes] or in group C [(48+/-6) minutes]. There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight loss and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively. As compared with prognosis nutritional index(PNI) postoperatively, those of 3 groups decreased significantly 6 months postoperatively. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (both P < 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively.

CONCLUSIONS

The new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy.

Authors+Show Affiliations

Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

chi

PubMed ID

18803041

Citation

Ye, Zai-yuan, et al. "[Clinical Study On the Alimentary Canal Reconstruction of Uncutted Roux-en-Y With Jejunal Pouch for Total Gastrectomy]." Zhonghua Wei Chang Wai Ke Za Zhi = Chinese Journal of Gastrointestinal Surgery, vol. 11, no. 5, 2008, pp. 424-7.
Ye ZY, Sun YS, Shi D, et al. [Clinical study on the alimentary canal reconstruction of uncutted Roux-en-Y with jejunal pouch for total gastrectomy]. Zhonghua Wei Chang Wai Ke Za Zhi. 2008;11(5):424-7.
Ye, Z. Y., Sun, Y. S., Shi, D., Shao, Q. S., & Xu, J. (2008). [Clinical study on the alimentary canal reconstruction of uncutted Roux-en-Y with jejunal pouch for total gastrectomy]. Zhonghua Wei Chang Wai Ke Za Zhi = Chinese Journal of Gastrointestinal Surgery, 11(5), 424-7.
Ye ZY, et al. [Clinical Study On the Alimentary Canal Reconstruction of Uncutted Roux-en-Y With Jejunal Pouch for Total Gastrectomy]. Zhonghua Wei Chang Wai Ke Za Zhi. 2008;11(5):424-7. PubMed PMID: 18803041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical study on the alimentary canal reconstruction of uncutted Roux-en-Y with jejunal pouch for total gastrectomy]. AU - Ye,Zai-yuan, AU - Sun,Yuan-shui, AU - Shi,Dun, AU - Shao,Qin-shu, AU - Xu,Ji, PY - 2008/9/23/pubmed PY - 2010/3/10/medline PY - 2008/9/23/entrez SP - 424 EP - 7 JF - Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery JO - Zhonghua Wei Chang Wai Ke Za Zhi VL - 11 IS - 5 N2 - OBJECTIVE: To investigate the efficacy of uncutted Roux-en-Y esophagojejunostomy with jejunal pouch (URYJP) after total gastrectomy. METHODS: Total gastrectomy was performed on 168 patients of gastric cancer, and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch was performed on 69 patients(group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients(group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C). The alimentary tract reconstruction time, morbidity and mortality were compared. The 121 cases that survived for more than 1 year were analyzed for quality of life(QOL),including body weight, intake quantity, prognosis nutritional index (PNI), and Visick scores 6 and 12 months after the operations. RESULTS: All the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found. It took (30+/-7) minutes to finish the reconstruction in group A, which was significantly shorter than that in group B [(57+/-6) minutes] or in group C [(48+/-6) minutes]. There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight loss and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively. As compared with prognosis nutritional index(PNI) postoperatively, those of 3 groups decreased significantly 6 months postoperatively. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (both P < 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively. CONCLUSIONS: The new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy. SN - 1671-0274 UR - https://www.unboundmedicine.com/medline/citation/18803041/[Clinical_study_on_the_alimentary_canal_reconstruction_of_uncutted_Roux_en_Y_with_jejunal_pouch_for_total_gastrectomy]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=1671-0274&amp;year=2008&amp;vol=11&amp;issue=5&amp;fpage=424 DB - PRIME DP - Unbound Medicine ER -