Impact of jejunal pouch interposition reconstruction after proximal gastrectomy for early gastric cancer on quality of life: short- and long-term consequences.
BACKGROUND
Proximal gastrectomy with jejunal pouch interposition (JPI) reconstruction has been advocated as a function-preserving surgery in patients with early gastric cancer located in the upper third of the stomach.


METHODS
This study clinically investigated 22 patients who underwent JPI reconstruction and 22 patients who underwent Roux-en-Y (RY) reconstruction after total gastrectomy for stage IA/IB gastric cancer. Patients in the 2 groups were compared to evaluate the short- and long-term postoperative outcomes.


RESULTS
Morbidity and nutritional parameters were no different between the 2 groups. Although postoperative food intake volume was significantly superior in JPI patients than in RY patients 1 year postsurgery, the change in body weight was equal. JPI patients outperformed RY patients with a better quality of life (QOL) at 1 year postgastrectomy. However, 5 years after the surgery, both groups had a similar QOL except for fatigue.


CONCLUSIONS
JPI reconstruction leads to better outcomes including QOL than RY reconstruction in the short term. However, this short-term positive impact of JPI decreases over time.
Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan. tsutomun@kochi-u.ac.jp
Tsutomu
T
Namikawa
Toyokazu
T
Oki
Hiroyuki
H
Kitagawa
Takehiro
T
Okabayashi
Michiya
M
Kobayashi
Kazuhiro
K
Hanazaki
D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D001835:Body Weight; D004435:Eating; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D019738:Surgically-Created Structures