Jejunal pouch reconstruction after total gastrectomy for cancer : a randomized controlled trial

The authors determined the optimum reconstruction procedure after total gastrectomy in terms of the quality of life of the patients. Gastric replacement with various enteric reservoirs has been used to improve the postprandial symptoms and nutrition of patients after total gastrectomy. However, the...

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Veröffentlicht in:Annals of surgery 1995-07, Vol.222 (1), p.27-35
Hauptverfasser: NAKANE, Y, OKUMURA, S, AKEHIRA, K, OKAMURA, S, BOKU, T, OKUSA, T, TANAKA, K, HIOKI, K
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container_end_page 35
container_issue 1
container_start_page 27
container_title Annals of surgery
container_volume 222
creator NAKANE, Y
OKUMURA, S
AKEHIRA, K
OKAMURA, S
BOKU, T
OKUSA, T
TANAKA, K
HIOKI, K
description The authors determined the optimum reconstruction procedure after total gastrectomy in terms of the quality of life of the patients. Gastric replacement with various enteric reservoirs has been used to improve the postprandial symptoms and nutrition of patients after total gastrectomy. However, the effect of each is uncertain because no prospective randomized studies have been conducted. A randomized controlled trial was conducted to compare the usefulness of the three reconstruction procedures of simple Roux-en-Y (RY; N = 10), pouch and Roux-en-Y (PR; N = 10), and pouch and interposition (PI; N = 10). In each subject, the postprandial symptoms, food intake in a single meal, body weight, serum nutritional parameters, and emptying time of the gastric substitute were evaluated. The PR group showed significantly greater food intake in a single meal than the RY and PI groups, and greater weight recovery than the PI group. A gastric emptying test also revealed satisfactory retention capacity and emptying time of the gastric substitute in the PR group. Pouch and Roux-en-Y reconstruction is the most useful of the three procedures for improving the postoperative quality of life. In patients with pouch and interposition reconstruction, the clinical assessment was quite poor, even though it is a physiologic route.
doi_str_mv 10.1097/00000658-199507000-00005
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Gastric replacement with various enteric reservoirs has been used to improve the postprandial symptoms and nutrition of patients after total gastrectomy. However, the effect of each is uncertain because no prospective randomized studies have been conducted. A randomized controlled trial was conducted to compare the usefulness of the three reconstruction procedures of simple Roux-en-Y (RY; N = 10), pouch and Roux-en-Y (PR; N = 10), and pouch and interposition (PI; N = 10). In each subject, the postprandial symptoms, food intake in a single meal, body weight, serum nutritional parameters, and emptying time of the gastric substitute were evaluated. The PR group showed significantly greater food intake in a single meal than the RY and PI groups, and greater weight recovery than the PI group. A gastric emptying test also revealed satisfactory retention capacity and emptying time of the gastric substitute in the PR group. Pouch and Roux-en-Y reconstruction is the most useful of the three procedures for improving the postoperative quality of life. In patients with pouch and interposition reconstruction, the clinical assessment was quite poor, even though it is a physiologic route.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-199507000-00005</identifier><identifier>PMID: 7618964</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Aged ; Anastomosis, Roux-en-Y - adverse effects ; Anastomosis, Roux-en-Y - methods ; Biological and medical sciences ; Body Weight ; Eating ; Female ; Gastrectomy - methods ; Humans ; Jejunum - diagnostic imaging ; Jejunum - physiology ; Jejunum - surgery ; Male ; Medical sciences ; Middle Aged ; Nutritional Status ; Postoperative Care ; Preoperative Care ; Prognosis ; Radionuclide Imaging ; Stomach Neoplasms - surgery ; Stomach, duodenum, intestine, rectum, anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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Gastric replacement with various enteric reservoirs has been used to improve the postprandial symptoms and nutrition of patients after total gastrectomy. However, the effect of each is uncertain because no prospective randomized studies have been conducted. A randomized controlled trial was conducted to compare the usefulness of the three reconstruction procedures of simple Roux-en-Y (RY; N = 10), pouch and Roux-en-Y (PR; N = 10), and pouch and interposition (PI; N = 10). In each subject, the postprandial symptoms, food intake in a single meal, body weight, serum nutritional parameters, and emptying time of the gastric substitute were evaluated. The PR group showed significantly greater food intake in a single meal than the RY and PI groups, and greater weight recovery than the PI group. A gastric emptying test also revealed satisfactory retention capacity and emptying time of the gastric substitute in the PR group. Pouch and Roux-en-Y reconstruction is the most useful of the three procedures for improving the postoperative quality of life. In patients with pouch and interposition reconstruction, the clinical assessment was quite poor, even though it is a physiologic route.</description><subject>Adult</subject><subject>Aged</subject><subject>Anastomosis, Roux-en-Y - adverse effects</subject><subject>Anastomosis, Roux-en-Y - methods</subject><subject>Biological and medical sciences</subject><subject>Body Weight</subject><subject>Eating</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Humans</subject><subject>Jejunum - diagnostic imaging</subject><subject>Jejunum - physiology</subject><subject>Jejunum - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nutritional Status</subject><subject>Postoperative Care</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Radionuclide Imaging</subject><subject>Stomach Neoplasms - surgery</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery (general aspects). 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Transplantations, organ and tissue grafts. 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recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1234751
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subjects Adult
Aged
Anastomosis, Roux-en-Y - adverse effects
Anastomosis, Roux-en-Y - methods
Biological and medical sciences
Body Weight
Eating
Female
Gastrectomy - methods
Humans
Jejunum - diagnostic imaging
Jejunum - physiology
Jejunum - surgery
Male
Medical sciences
Middle Aged
Nutritional Status
Postoperative Care
Preoperative Care
Prognosis
Radionuclide Imaging
Stomach Neoplasms - surgery
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
title Jejunal pouch reconstruction after total gastrectomy for cancer : a randomized controlled trial
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