JEJUNAL POUCH RECONSTRUCTION AFTER TOTAL GASTRECTOMY FOR CANCER - A RANDOMIZED CONTROLLED TRIAL

被引:162
作者
NAKANE, Y
OKUMURA, S
AKEHIRA, K
OKAMURA, S
BOKU, T
OKUSA, T
TANAKA, K
HIOKI, K
机构
[1] 2nd Department of Surgery, Kansai Medical University, Osaka
关键词
D O I
10.1097/00000658-199507000-00005
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective The authors determined the optimum reconstruction procedure after total gastrectomy in terms of the quality of life of the patients. Summary Background Data 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. Methods 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. Results 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. Conclusions 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.
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页码:27 / 35
页数:9
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