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[Comparison of different alimentary reconstructions after total gastrectomy for cancer]
1Abdominal Department, Neoplasm Hospital, Tianjin Medical University, Tianjin 300060.
Objective:
To study the optimum reconstruction after total gastrectomy for malignant disease, especially the necessity of gastric substitute and duodenal passage.
Methods:
Among 75 patients having total gastrectomy, five kinds of reconstruction were used: Braun, modified Braun (mBraun) I, II, III, and antigrade jejunal interposition (AJI). Postoperative complaints, body weight, food intake, serum nutritional parameters, complete blood count, half-emptying time of the gastric substitute, PNI, Visick index were evaluated.
Results:
As compared with Braun group, the mBraun I and II groups showed less reflux esophagitis, higher nutritional parameters and PNI, while the operation time was similar. As compared with mBraun I and II groups, mBraun III and AJI groups showed better body weight, higher nutritional parameters, and PNI.
Conclusions:
It is essential to construct a gastric substitute and maintain the alimentary tract flowing through the duodenum after total gastrectomy for cancer, and the AJI may be a better choice in the operation of gastrectomy.