Jejunal Pouch Double Tract versus Reux-en-Y Reconstruction after Total Gastrectomy for Gastric Cancer

Yasumasa Kondoh, Yasuo Kajiura¹⁾, Kenji Nakamura, Masao Miyaji, Kyoji Ogoshi, Tomoo Tajima and Hiroyasu Makuuchi²⁾

Department of Surgery, Tokai University Tokyo Hospital¹⁾
Department of Surgery, Tokai University School of Medicine²⁾

The aim of the study was to elucidate the clinical assessment after total gastrectomy for gastric cancer. The records of 24 patients who underwent resection without apparent residual tumors were evaluated to compare two reconstruction procedures, Roux-en-Y esophagojejunostomy (R-Y, n=15) and jejunal pouch according to double tract reconstruction (JPD, n=9). No anastomotic leakage was found in either group. Length of operation time for JPD was shortened using stapling devices. The nutritional status (including white blood cell and lymphocyte counts, hemoglobin, total protein, serum albumin and total cholesterol levels), and bodyweight were assessed from the preoperative period to three years after operation. No difference between the nutritional status of R-Y (n=11) and JPD (n=6) in patients with curative resections was found. From three months to two years after operation, bodyweight loss of JPD (n=6, 4.5±6.5∼6.1±5.5%) were lower than that of R-Y (n=11, 11.3±2.9∼15. 6±3.9%) in patients with curative resections (p<0.05). These results suggest that the JPD procedure is an acceptable reconstruction method after total gastrectomy for gastric cancer.

Key words
nutrition, jejunal pouch, double tract reconstruction, Roux-en-Y reconstruction, total gastrectomy

Reprint requests
Yasumasa Kondoh Department of Surgery, Tokai University Tokyo Hospital 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053 JAPAN

Accepted
December 9, 1998

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