Total gastrectomy with substitution of stomach by jejunal pouch with and without duodenal passage. Study in rats.
OBJECTIVE
A comparison was done between the F. Paulino jejunal pouch (FP) and a jejunal pouch (JP) as esophagus-duodenum interpositional graft, for replacing the stomach after total gastrectomy. It was investigated the effect of the two procedures on esophagus histology, nutritional state and serum gastrin in rats.


METHODS
Male Wistar rats weighing 282 +/- 17g were randomly submitted to sham operation (S), FP and JP after total gastrectomy. After eight weeks the rats were killed with overdose of anesthetic and tissue was taken from the distal esophagus for histology. Serum levels of total proteins, albumin, iron, transferring, folate, cobalamine, calcium, as well as serum gastrin were determined. Survival was considered.


RESULTS
Fourty six rats were operated and thirty survived for eight weeks. Five (33.3%) died after FP and 11 (52.3%) after JP (p < 0.05). Postoperative esophagitis occurred in 6 JP rats. At 8th week, no difference was observed on body weight when compared FP and JP rats (p > 0.05). The JP rats had a significant decrease in serum albumin, glucose, transferrin, iron, folate and calcium, compared to sham (p < 0.05). Serum gastrin, iron and calcium were significantly higher in JP rats than in FP rats (p < 0.05). In FP rats, transferrin and cobalamine showed significant decrease comparing the preoperative with 8th week levels (p < 0.05).


CONCLUSIONS
F. Paulino pouch in rats had lower mortality than JP, and esophagitis was not detected in it. JP rats had serum gastrin, iron and calcium unaffected, possibly because of preservation of duodenal passage.
Aires Neto
Tertuliano
T
Núcleo de Cirurgia Experimental, Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil.
Cavalcante
Jeancarlo Fernandes
JF
Brandão-Neto
José
J
Almeida
Maria das Graças
Md
de Rezende
Adriana Augusto
AA
Egito
Eryvaldo Sócrates Tabosa
ES
de Azevedo
Italo Medeiros
IM
Pinheiro
Laísa Araújo Mohana
LA
Medeiros
Vítor Brasil
VB
Medeiros
Aldo da Cunha
Ada C
D000704:Analysis of Variance; D000713:Anastomosis, Roux-en-Y; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D004386:Duodenum / Q000601:surgery*; D004942:Esophagitis, Peptic / Q000503:physiopathology; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D005755:Gastrins / Q000097:blood; D007583:Jejunum / Q000601:surgery*; D008297:Male; D009752:Nutritional Status; D011178:Postgastrectomy Syndromes / Q000209:etiology; D051381:Rats; D017208:Rats, Wistar; D012709:Serum Albumin / Q000032:analysis; D014805:Vitamin B 12 / Q000097:blood
D001786:Blood Glucose; D005755:Gastrins; D012709:Serum Albumin; D014805:Vitamin B 12