title: Uncut Esophagojejunostomy with Double Jejunal Pouch: An Alternative Reconstruction Method that Improves the Quality of Life of Patients after Total Gastrectomy.
abstract: BACKGROUND
  Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed.
  
  
  METHODS
  Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy. According to the reconstruction methods used, these patients were divided into three groups: UJEA-DJP (n = 63), Roux-en-Y (n = 45), and P-loop with Roux-en-Y esophagojejunostomy (P-RY; n = 52). The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick classification among the three groups were analyzed.
  
  
  RESULTS
  We found that UJEA-DJP has advantages over Roux-en-Y and P-RY regarding the time of digestive tract reconstruction, incidence rates for long-term complications, postoperative nutritional index, body weight recovery, and the Visick classification for subjective feelings (p < .05).
  
  
  CONCLUSIONS
  The UJEA-DJP surgical procedure has the advantages of intestinal continuity and double-pouch construction, which can significantly reduce long-term complications and improve the long-term quality of life of patients after surgical procedure.
authors.affiliation: a Center of General Surgery , The People's Liberation Army General Hospital of Chengdu Command , Chengdu, Sichuan Province , China.
authors.forename: Jia Qing
authors.initials: JQ
authors.lastname: Gong
authors.affiliation: a Center of General Surgery , The People's Liberation Army General Hospital of Chengdu Command , Chengdu, Sichuan Province , China.
authors.forename: Yong Kuan
authors.initials: YK
authors.lastname: Cao
authors.affiliation: a Center of General Surgery , The People's Liberation Army General Hospital of Chengdu Command , Chengdu, Sichuan Province , China.
authors.forename: Guo Hu
authors.initials: GH
authors.lastname: Zhang
authors.affiliation: a Center of General Surgery , The People's Liberation Army General Hospital of Chengdu Command , Chengdu, Sichuan Province , China.
authors.forename: Pei Hong
authors.initials: PH
authors.lastname: Wang
authors.affiliation: a Center of General Surgery , The People's Liberation Army General Hospital of Chengdu Command , Chengdu, Sichuan Province , China.
authors.forename: Guo De
authors.initials: G
authors.lastname: Luo
mesh_terms: D034861:Abdominal Wall; D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods*; D039021:Colonic Pouches; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: digestive tract reconstruction; double jejunal pouch; gastric cancer; jejunal esophageal anastomosis; total gastrectomy; uncut