title: Postoperative functional evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer.
abstract: BACKGROUND
  The objective of this study was to compare the motility of a gastric substitute after jejunal interposition without a pouch and jejunal interposition with a pouch and to evaluate the relationship of both methods with nutritional outcome.
  
  
  METHODS
  Twelve patients with gastric cancer treated by total gastrectomy and reconstruction with jejunal interposition without a pouch (J-I) and 14 patients treated by total gastrectomy and reconstruction with jejunal interposition with a pouch (J-P) were investigated in regard to the motor activity of the interposed jejunum and changes in body weight and dietary intake.
  
  
  RESULTS
  Phase III of the interposed jejunum without a pouch was observed over a 3-month follow-up, but phase III of the interposed jejunum with a pouch was not observed in any patient within 3 months of surgery. In the fed state, the motor activity of the interposed jejunum without a pouch increased significantly in patients within 12 months of follow-up, but in the interposed jejunum with a pouch, it did not. The amount of food consumed by the J-I group was significantly greater than that consumed by the J-P group.
  
  
  CONCLUSIONS
  This study demonstrates that the interposed jejunum with a pouch shows marked disturbances from the motor pattern of a normal jejunum during the fasting and fed states. These motor abnormalities may be responsible for insufficient food intake of the J-P group.
authors.affiliation: First Department of Surgery, Faculty of Medicine, Gunma University, 3-39-15, Showa-machi, Maebashi 371-8511, Japan. emochiki@showa.gunma-u.ac.jp
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kamiyama
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Aihara
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nakabayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kamimura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D001835:Body Weight; D004435:Eating; D005260:Female; D005743:Gastrectomy; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007583:Jejunum / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D013274:Stomach Neoplasms / Q000601:surgery*