title: [Application of jejunal interposition after radical proximal gastrectomy].
abstract: OBJECTIVE
  To explore an ideal method of digestive tract reconstruction and tolerance to adjuvant chemotherapy after radical proximal gastrectomy.
  
  
  METHODS
  Thirty patients in the reconstruction group were treated by jejunal interposition, and other 30 patients received gastroesophagostomy (control group). The operation time, operation risk, occurrence of reflux esophagitis and postoperative 1-, 3-, 6-month nutrition statuses were evaluated. Forty-three patients received postoperative adjuvant chemotherapy with mFOLFOX-6 and tolerance to the chemotherapy was assessed.
  
  
  RESULTS
  The operation time of the reconstructional group was (162.2 ± 14.0)min and that of the control group was (137.6 ± 18.9)mi, with a statistically significant difference. (t = -5.7, P<0.01). There were no significant differences of operation risk, postoperative 2-, 4-, and 6-day C-reactive protein, 2-, 4- and 6-day systemic inflammatory response syndrome between the two groups. The differences of the occurrence of postoperative 1-, 3- and 6-month reflux esophagitis and 3- and 6-month nutritional status between the two groups were statistically significant. 18 of 19 (94.7%) patients in the reconstruction group completed all six cycles of chemotherapy, 24 patients in the control group received chemotherapy, and 12 (50.0%) of them completed 6 cycles of chemotherapy. There was a significant difference in the completion rate of chemotherapy of the two groups (P<0.05).
  
  
  CONCLUSIONS
  The postoperative complications of jejunal interposition are not inceased, the symptoms of reflux esophagitis are alleviated, the quality of life can be improved, and there is a better tolerance to adjuvant chemotherapy. Therefore, jejunal interposition after radical proximal gastrectomy is a rational method of digestive tract reconstruction.
authors.affiliation: Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: She-qing
authors.initials: SQ
authors.lastname: Ji
authors.forename: Ya-wei
authors.initials: YW
authors.lastname: Hua
authors.forename: Ying-qiang
authors.initials: YQ
authors.lastname: Liu
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology
chemical_list: D009944:Organoplatinum Compounds; D002097:C-Reactive Protein; D002955:Leucovorin; D005472:Fluorouracil