Postoperative functional evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer.
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.
Mochiki
Erito
E
First Department of Surgery, Faculty of Medicine, Gunma University, 3-39-15, Showa-machi, Maebashi 371-8511, Japan. emochiki@showa.gunma-u.ac.jp
Kamiyama
Yoichi
Y
Aihara
Ryusuke
R
Nakabayashi
Toshihiro
T
Kamimura
Hitoshi
H
Asao
Takayuki
T
Kuwano
Hiroyuki
H
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*