title: Roux-en-Y reconstruction with stapled distal jejunal pouch after total gastrectomy.
abstract: 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.
authors.affiliation: Digestive Surgery and Surgical Oncology, Kagoshima University School of Medicine, Kagoshima, Japan. ishiga@m.kufm.kagoshima-u.ac.jp
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Aridome
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakajo
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Hideo
authors.initials: H
authors.lastname: Arima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Takashi
authors.initials: T
authors.lastname: Aikou
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: 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