Evaluation of Reconstructive Procedures Following Total Gastrectomy in the Patients Who Lived More than 3 Postoperative Year -The Comparsion of Roux-en-Y and Jejunal Interposition-

Masayuki Sho, Atsushi Imagawa, Takasumi Hosoi, Masatoshi Yamamoto, Mannosuke Yagura, Akihiko Watanabe*, Hiroshige Nakano*

Department of Surgery, Saiseikai Chuwa Hospital
*The First Department of Surgery, Nara Medical University

To clarify the usefulness of two different reconstructive procedures after total gastrectomy for gastric cancer, we evaluated the clinical results and quality of life of 35 patients with no evidence of disease more than three years after operation. Roux-en-Y (RY group; n=15) reconstruction or jejunal interposition (IP group; n=20) reconstruction was performed. The body wieght ratio (RY group: 90.0%, IP group: 93.6%) and body mass index (RY group: 19.0 IP group: 19.6) were similar in both groups. Blood analysis and blood chemistry tests were almost within normal limits in both groups, and did not show statistically significant differences between the two groups. The pancreatic function diagnostic test did not show significant difference between the two groups. Blood glucose levels determined by the oral glucose tolerance test were similar in the two groups. Plasma insulin levels in the IP group at 60 and 120 minutes after the glucose load were significantly higher than those in the RY group. The patient's evaluation of treatment and postoperative life in the IP group was significantly better than that in the RY group. The quality of life evaluated by a questionnaire concerning postoperative or postpranidal symptoms was almost the same and good in both groups. In other clinical data and clinical symptoms except for a feeling of satisfaction, the two different reconstructive procedures following total gastrectomy showed few statistically significant differences and both procedures were acceptable.

Key words
total gastrectomy, Roux-en-Y reconstruction, jejunal interposition, quality of life, gastric cancer

Reprint requests
Masayuki Sho The First Department of Surgery, Nara Medical University
840, Shijyo-chu, Kashihara-city, 634 JAPAN

Accepted
July 10, 1996

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