Roux-en-Y reconstruction with stapled distal jejunal pouch after total gastrectomy.
Roux-en-Y reconstruction after total gastrectomy is a simple and safe procedure; however, it eliminates the gastric reservoir function and markedly changes the postoperative digestive physiology. The patients therefore suffer from insufficient food intake and malabsorption. It has been reported that jejunal pouch reconstruction increases food intake and improves the nutritional status. We established a novel Roux-en-Y reconstruction with stapled distal jejunal pouch after total gastrectomy. A jejunal pouch, 8 cm in size, was attached at the jejunojejunostomy. We performed this novel reconstruction for 20 gastric cancer patients after total gastrectomy with lymph node dissection as a feasible study. One year after operation, the average percentage weight was maintained in more than 90 per cent and 17 (85%) of these patients were in the normal range of the body mass index. This procedure may improve postoperative malnutrition after total gastrectomy according to our feasible study. A multicenter randomized trial of this approach comparing with Roux-en-Y reconstruction without a pouch is ongoing.
Ishigami
Sumiya
S
Digestive Surgery and Surgical Oncology, Kagoshima University School of Medicine, Kagoshima, Japan. ishiga@m.kufm.kagoshima-u.ac.jp
Aridome
Kuniaki
K
Nakajo
Akihiro
A
Matsumoto
Masataka
M
Uchikado
Yasuto
Y
Setoyama
Tetsuro
T
Arigami
Takaaki
T
Arima
Hideo
H
Ueno
Shinichi
S
Kijima
Yuko
Y
Aikou
Takashi
T
Natsugoe
Shoji
S
D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D015331:Cohort Studies; D004947:Esophagus / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D017792:Surgical Stapling; D019738:Surgically-Created Structures; D016896:Treatment Outcome