A pilot study comparing jejunal pouch and jejunal interposition reconstruction after proximal gastrectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Surgical Innovation

Background:

• Increasing incidence of proximal gastric cancer necessitates organ-preserving surgical techniques.
• Proximal gastrectomy is frequently employed to maintain gastric function.
• Optimal reconstruction methods post-proximal gastrectomy remain a subject of debate.

Purpose of the Study:

• To compare the efficacy of jejunal pouch interposition versus jejunal interposition for reconstruction after proximal gastrectomy.
• To evaluate postoperative morbidity and patient-reported symptoms between the two reconstruction techniques.

Main Methods:

• A prospective pilot study involving 38 patients with early proximal gastric cancer.
• Randomized assignment of patients to either jejunal interposition (IP group) or jejunal pouch interposition (PO group).
• Comparison of postoperative morbidity, gastrointestinal complaints, and caloric intake between the groups.

Main Results:

• Jejunal pouch interposition (PO group) demonstrated significantly lower postoperative morbidity compared to jejunal interposition (IP group) (p = 0.036).
• Patients in the IP group experienced more frequent gastrointestinal complaints up to 6 months post-surgery.
• The PO group showed more favorable caloric intake up to 1 year post-surgery.

Conclusions:

• Jejunal pouch interposition offers superior short-term and mid-term outcomes compared to jejunal interposition following proximal gastrectomy.
• Jejunal pouch interposition may lead to better patient recovery and nutritional status.