OBJECTIVETo investigate the mechanism of reconstruction procedures affecting intestinal motility after total gastrectomy.

METHODSBeagle dogs were divided into 3 groups:3 dogs in sham operation group, 7 in functional jejunal interposition (FJI) group, and 3 in Roux-en Y(RY) group. These dogs were sacrificed 48 hours postoperatively. Dogs were gavaged with active carbon 1 h before sacrifice and the intestinal transit rate was evaluated. Intestinal tissues 5 cm away from the duodenojejunal anastomosis were collected for detecting inflammation, interstitial cells of Cajal (ICC), and apoptosis using HE staining, immunohistochemistry, and interference microscope respectively.

RESULTSThe intestinal transit rate in sham and FJI group (0.14 ± 0.03 and 0.32 ± 0.11) was lower than that in RY group (0.52 ± 0.21, P<0.05), which indicated FJI procedure had better food storage. More ICCs were found in submucosa of FJI group than those of RY group. Inflammation in serosal side of the intestine, including hemorrhage, fibrin deposition, and ulceration, neutrophil and macrophage infiltration, and intestinal epithelial cell apoptosis were significantly reduced in FJI group as compared to RY group, which indicated that amelioration of intestinal inflammation and damage might contribute to reducing ICC loss in FJI group.

CONCLUSIONSAs a reconstruction procedure with less traumatic and intestinal continuity preserving, FJI has better reservoir function and quicker recovery of intestinal motility.