Evaluation of Jejunal Pouch Reconstruction after Total Gastrectomy

Kazuya Miyoshi, Sadanori Fuchimoto, Toshihide Ohsaki, Tatsuhiko Sakata, Isao Takeda, Kenji Takahashi, Takaomi Ohkawa, Toshihiro Murata, Kimiaki Tanaka and Norihisa Takakura^*

Department of Surgery, Fukuyama National Hospital
^*First Department of Surgery, Okayama University Medical School

The objective of this study was to evaluate which reconstruction method results in the best quality of life after total gastrectomy. A total of 48 patients underwent the following reconstructions: pouch and Roux-en-Y (PRY) (N=23), pouch and interposition (PI) (N=12) or Roux-en-Y without pouch (RY) (N=13). The subjective symptoms, the quantity of meals, the body weight, the serum nutritional parameters and the retention rate of isotope labeled meal in correlation to reconstruction type were documented. Twelve months after operation, PRY and PI groups were found to have significantly better quantity of meals (p<0.05) and higher body weight. However, a few patients in the PI group complained of refractory postprandial symptoms (vomiting or regurgitation) and showed severe retention of isotope in the pouch. We conclude, PRY is the better reconstruction method than PI and PRY within the first 12 months after total gastrectomy.

Key words
jejunal pouch, total gastrectomy, Roux-en-Y reconstruction, interposition reconstruction

Reprint requests
Kazuya Miyoshi Department of Surgery, Fukuyama National Hospital, 4-14-17 Okinogami-cho, Fukuyama, 720-0825 JAPAN

Accepted
January 26, 2000

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