title: Total gastrectomy: the influence of preserved duodenal transit and of pouch reconstruction on abdominal symptoms, nutrient assimilation, and medico-social functioning.
abstract: OBJECTIVE
  The aim of this retrospective study was to establish whether patients with different reconstruction after total gastrectomy (duodenal bypass without pouch (subgroup Ia, n = 88); duodenal bypass with pouch (subgroup Ib, n = 27); continuous duodenal transit (subgroup II, n = 27)) differ concerning abdominal symptoms, nutrient assimilation, and medico-social functioning.
  
  
  METHODS
  The 142 patients (49 females, 93 males; mean age 57.2 years, (95% confidence interval 55 to 59)) after potentially curative total gastrectomy for gastric malignancy 500 days earlier (mean: 95% confidence interval 334 to 666) were evaluated for abdominal symptoms, biochemical and haematological parameters, endoscopic findings, small intestinal bacterial overgrowth, oro-caecal transit time, objective signs of malassimilation, and the degree of medico-social functioning.
  
  
  RESULTS
  There were no significant differences between the subgroups in any of the parameters examined.
  
  
  CONCLUSIONS
  In this study, neither subjective nor objective patient data support preference for any single mode of the examined reconstructions after total gastrectomy. However, small patient numbers, unstandardised reconstruction procedures and a recruitment bias might influence these findings.
authors.affiliation: Department of Gastroenterology, University Hospital, Maastricht, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Brägelmann
authors.forename: U
authors.initials: U
authors.lastname: Armbrecht
authors.forename: D
authors.initials: D
authors.lastname: Rosemeyer
authors.forename: B
authors.initials: B
authors.lastname: Schneider
authors.forename: W
authors.initials: W
authors.lastname: Zilly
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
mesh_terms: D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016737:Proctocolectomy, Restorative; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*