[Residual stomach, duodenum, and continual jejunal interposition after subtotal gastrectomy].
OBJECTIVE
To investigate the clinical effect of residual stomach, duodenum, and continual jejunal interposition on the patients of gastric cancer after subtotal gastrectomy.


METHODS
Fifty-four patients with gastric cancer after subtotal gastrectomy were randomly divided into 2 groups: Group A (n = 26, receiving digestive tract reconstruction by manual end-to-side anastomosis of residual stomach and jejunum, end-to-side anastomosis of residual duodenum and jejunum, and side-to-side anastomosis of jejunum and jejunum, then the jejunum proximal to the stomach-jejunum anastomosis and the jejunum distal to the duodenum-jejunum anastomosis were ligated so as to form an integral continual jejunal interposition; and Group B (n = 28, receiving Bilroth digestive tract reconstruction. The operation time, body weight, prognosis nutrition index (PNI), and Visick score 3 and 6 months after the operation were observed.


RESULTS
All patients recovered quickly and no complicating anastomosis leakage and obstruction was found. It took 53 +/- 9 minutes to finish the reconstruction in Group A, significantly shorter than that in Group B (57 +/- 6 minutes, t = -2.145, P = 0.037). The body weight and PNI of both groups decreased significantly 3 months after the operation in comparison with those before the operation (both P < 0.05). The body weight and PNI of Group A returned to the levels before operation. Although the body weight and PNI of Group B recovered to some extent 6 months after operation, they remained significantly lower than those before operation both P < 0.05). The Visick score 6 months after operation of Group A was superior to that of Group B (t = 2.1 P < 0.05).


CONCLUSIONS
Residual stomach, duodenum, and continual jejunal interposition after subtotal gastrectomy helps overcome the difficulty in the procedure of digestive tract reconstruction and restore the physiological passage through duodenum, thus avoiding reflux and improving patients' quality of life.
Zhang
Qin
Q
Department of Gastrointestinal Surgery, Affiliated Hospital, Zhejiang College of Traditional Chinese Medicine, Hangzhou 310006, China. zhangqinhz@mail.hz.zj.cn
Ye
Zai-yuan
ZY
Yu
Jian-fa
JF
Zhang
Rui-lin
RL
Xu
Ji
J
Ye
Sheng-ya
SY
Zhang
Qi
Q
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*