A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition?
OBJECTIVE
To determine the optimum pouch reconstruction after total gastrectomy, we conducted a randomized trial to compare the usefulness between PR and PI in terms of quality of life.


METHODS
Thirty patients younger than 70 years of age were selected and randomly classified into the following 2 groups: pouch and Roux-en-Y (PR; n = 15) and pouch and interposition (PI; n = 15). In each subject, the postoperative symptoms, food intake in a single meal, body weight, serum nutritional parameters, endoscopy, emptying time of the gastric substitute, and gallstone formation were evaluated.


RESULTS
There were no significant differences in terms of the postprandial symptoms, food intake, body weight, and serum nutritional parameters until 2 years postoperative. Endoscopy showed a tendency of food stasis in the PR group, although this was not significant. The gastric emptying test in the PR group indicated that the retention capacity was slightly superior to that in the PI group.


CONCLUSIONS
The impact of the duodenal passage on symptoms and nutrition could not be ascertained.
Nakane
Y
Y
Second Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570, Japan.
Michiura
T
T
Inoue
K
K
Iiyama
H
H
Okumura
S
S
Yamamichi
K
K
Hioki
K
K
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000601:surgery*