title: Evaluation of double tract reconstruction after total gastrectomy in patients with gastric cancer: prospective randomized controlled trial.
abstract: BACKGROUND
  The double tract (DT) method was compared with the Roux-en-Y (R-Y) method to identify the optimal reconstruction procedure after total gastrectomy for patients with gastric cancer. The DT reconstruction is as simple as the R-Y, and it can be safely performed even after total gastrectomy. However, these have been no studies evaluating the usefulness of DT reconstruction in comparison to R-Y reconstruction.
  
  
  METHODS
  A group of 44 patients with gastric cancer were intraoperatively randomized for R-Y (n = 23) or DT reconstruction (n = 21) after total gastrectomy (TG). Body weight, food intake, nutritional conditions, and quality of life (QOL) were determined at 3 and 12 months after the operation. This study is registered with ClinicalTrials.gov, no. NCT00746161.
  
  
  RESULTS
  Food intake significantly decreased soon after the operation. No differences were observed between the DT and R-Y groups. The body weight decreased throughout the ensuing period (P < 0.05) and thereafter gradually recovered. However, no differences were observed between the two groups. Among the nutritional laboratory parameters, serum prealbumin, retinol-binding protein, total cholesterol, and triglyceride were decreased soon after the operation. The changes of those parameters were not substantially different between the two groups. The postoperative QOL was evaluated, and no differences were observed between those groups.
  
  
  CONCLUSIONS
  There were no particular advantages in the DT method after TG in comparison to the simple R-Y method in terms of body weight, QOL, and nutritional conditions, suggesting that the DT method might not be recommended after TG for patients with gastric cancer.
authors: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
authors: Makoto
authors: M
authors: Iwahashi
authors: Mikihito
authors: M
authors: Nakamori
authors: Masaki
authors: M
authors: Nakamura
authors: Teiji
authors: T
authors: Naka
authors: Toshiyasu
authors: T
authors: Ojima
authors: Takeshi
authors: T
authors: Iida
authors: Masahiro
authors: M
authors: Katsuda
authors: Kentaro
authors: K
authors: Ueda
authors: Hiroki
authors: H
authors: Yamaue
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome