title: [Comparison of two types of digestive tract reconstruction after total gastrectomy in patients with gastric carcinoma].
abstract: OBJECTIVE
  To evaluate the influence of two different types of digestive tract reconstruction on the life quality, nutritional status and tolerance to adjuvant chemotherapy after total gastrectomy in patients with gastric carcinoma.
  
  
  METHODS
  The clinical data of a total of 107 patients treated in our department from January 2005 to december 2008 were analyzed retrospectively. Among them, 49 patients underwent digestive tract reconstruction with functional jejunal interposition (FJI group) and 58 patients underwent Roux en-Y jejunal P-type anastomosis (PR group) after total gastrectomy. 79 of 107 (73.8%) patients received postoperative adjuvant chemotherapy with XELOX regimen. The digestive complications and tolerance to chemotherapy were assessed respectively.
  
  
  RESULTS
  Neither severe complications nor surgery-related or chemotherapy-related death were observed among the 107 patients. There were statistical differences in the incidence rate of emaciation, dumping syndrome and retention syndrome between the FJI and PR groups (P < 0.05), but no significant statistical difference in incidence rate of reflux esophagitis (P > 0.05). 28 of 40 (70.0%) patients in the FJI group completed all six cycles of chemotherapy, while 12 (30.0%) patients interrupted the treatment due to chemotherapy-related toxicity. 39 patients in the PR group received chemotherapy, 19 (48.7%) of them completed 6 cycles of chemotherapy but 20 (51.3%) patients interrupted. There was a significant difference in the incidence rate of grade III/IV chemotherapeutic toxicity and completion rate of chemotherapy (P < 0.05).
  
  
  CONCLUSIONS
  Both functional jejunal interposition and Roux-Y operation are reasonable and safe procedures of digestive tract reconstruction. The incidence rates of emaciation, dumping syndrome and retention syndrome are lower in the patients with FJI, showing a better tolerance to adjuvant chemotherapy than Roux en-Y jejunal p type anastomosis.
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University, Guangzhou 510060, China. c.yingbo@medmail.com.cn
authors.forename: Ying-bo
authors.initials: YB
authors.lastname: Chen
authors.forename: Yuan-fang
authors.initials: YF
authors.lastname: Li
authors.forename: Xing-yu
authors.initials: XY
authors.lastname: Feng
authors.forename: Zhi-wei
authors.initials: ZW
authors.lastname: Zhou
authors.forename: You-qing
authors.initials: YQ
authors.lastname: Zhan
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Sun
authors.forename: Da-zhi
authors.initials: DZ
authors.lastname: Xu
authors.forename: Yuan-xiang
authors.initials: YX
authors.lastname: Guan
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods; D000714:Anastomosis, Surgical / Q000379:methods; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D009752:Nutritional Status; D010071:Oxaloacetates; D011184:Postoperative Period; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000601:surgery*
chemical_list: D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil