title: [Comparative study on three types of digestive reconstruction after total gastrectomy].
abstract: OBJECTIVE
  To investigate the rational digestive reconstruction after total gastrectomy for gastric malignancy.
  
  
  METHODS
  Three types of digestive reconstruction were performed after total gastrectomy in 189 cases with gastric carcinoma. The operating time, morbidity and mortality, food intake, digestive tract symptoms, nutritional status at 1 and 3 years after surgery and 1-, 3-, 5-year cumulative survival were compared.
  
  
  RESULTS
  There were no significant differences among the three procedures in operative morbidity and mortality, postoperative food intake, nutritional status (Hemoglobin, total protein and labium), and incidences of diarrhea and dumping syndrome (P > 0.05). The overall 1-, 3-, 5-year survival rates were 75.3%, 38.2% and 20.5% respectively, and there were no significant differences among the three groups (P > 0.05). Orr-type and P-type esophagojejunostomy had an advantage of anti-esophageal reflux, and were obviously superior to Moynihan-type anastomosis (P< 0.01). Compared with P-type reconstruction, Orr-type reconstruction was simpler with shorter operating time, and less complications.
  
  
  CONCLUSIONS
  Orr-type Roux-en-Y esophagojejunostomy can be recommended as an adaptable method of digestive reconstruction after total gastrectomy for gastric cancer because of its avoiding reflux esophagitis, maintaining better nutritional status and quality of life, and simpler procedure.
authors.affiliation: Department of Gastrointestinal Surgery, The Thir d Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China. drwhb@21cn.com
authors.forename: Hong-bo
authors.initials: HB
authors.lastname: Wei
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.forename: Zong-heng
authors.initials: ZH
authors.lastname: Zheng
authors.forename: Feng
authors.initials: F
authors.lastname: Zheng
authors.forename: Wan-shou
authors.initials: WS
authors.lastname: Qiu
authors.forename: Wei-ping
authors.initials: WP
authors.lastname: Guo
authors.forename: Tu-feng
authors.initials: TF
authors.lastname: Chen
authors.forename: Tian-bao
authors.initials: TB
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*