Comparative study on three types of digestive reconstruction after total gastrectomy.
- Author:
Hong-bo WEI
1
;
Bo WEI
;
Zong-heng ZHENG
;
Feng ZHENG
;
Wan-shou QIU
;
Wei-ping GUO
;
Tu-feng CHEN
;
Tian-bao WANG
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Anastomosis, Roux-en-Y; methods; Esophagus; surgery; Female; Gastrectomy; Humans; Jejunum; surgery; Male; Middle Aged; Postoperative Period; Reconstructive Surgical Procedures; methods; Stomach Neoplasms; surgery
- From: Chinese Journal of Gastrointestinal Surgery 2006;9(4):301-304
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the rational digestive reconstruction after total gastrectomy for gastric malignancy.
METHODSThree types of digestive reconstruction were performed after total gastrectomy in 189 cases with gastric carcinoma. The operating time, morbidity and mortality, food intake, digestive tract symptoms, nutritional status at 1 and 3 years after surgery and 1-, 3-, 5-year cumulative survival were compared.
RESULTSThere were no significant differences among the three procedures in operative morbidity and mortality, postoperative food intake, nutritional status (Hemoglobin, total protein and labium), and incidences of diarrhea and dumping syndrome (P > 0.05). The overall 1-, 3-, 5-year survival rates were 75.3%, 38.2% and 20.5% respectively, and there were no significant differences among the three groups (P > 0.05). Orr-type and P-type esophagojejunostomy had an advantage of anti-esophageal reflux, and were obviously superior to Moynihan-type anastomosis (P< 0.01). Compared with P-type reconstruction, Orr-type reconstruction was simpler with shorter operating time, and less complications.
CONCLUSIONSOrr-type Roux-en-Y esophagojejunostomy can be recommended as an adaptable method of digestive reconstruction after total gastrectomy for gastric cancer because of its avoiding reflux esophagitis, maintaining better nutritional status and quality of life, and simpler procedure.