Does Roux-en Y reconstruction with jejunal pouch after total gastrectomy prevent complications of postgastrectomy?
OBJECTIVE
To evaluate the efficacy of a jejunal pouch after a total gastrectomy with Roux-en Y reconstruction.


METHODS
Thirty patients with gastric cancer who had a total gastrectomy as a radical operation and had no recurrence were enrolled in this study. The jejunal pouch was added to Roux-en Y reconstruction in 15 patients (J-pouch group) and was not added in the other 15 patients (Roux en-Y group). A questionnaire survey which consisted of dietary intake, postprandial abdominal complaints and body weight, blood examination (hemoglobin, total protein, albumin), were conducted. The 99mTc-DTPA with semi-liquid diet emptying test and the manometry in the jejunal pouch were evaluated in 12, 2 of the J-pouch group, respectively.


RESULTS
There were no significant differences between the two groups in the questionnaire survey and blood examination. The half emptying time (T1/2) of 99mTc-DTPA was over 60 minutes in 9 of the 12 J-pouch group. The manometric study did not reveal the effective contraction of the jejunal pouch. Bypass operation was necessary due to marked delay of emptying in the jejunal pouch for one patient in the J-pouch group.


CONCLUSIONS
The advantage of adding a jejunal pouch to Roux en-Y reconstruction was not proven in this study.
Kurita
Nobuhiro
N
Department of Surgery, University of Tokushima, Kuramoto 3-18-15, Tokushima 770-8503, Japan.
Shimada
Mitsuo
M
Chikakiyo
Motoya
M
Miyatani
Tomohiko
T
Higashijima
Jyun
J
Yoshikawa
Kouzou
K
Nishioka
Masanori
M
Iwata
Takashi
T
D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000379:methods*; D005746:Gastric Emptying; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011795:Surveys and Questionnaires