[Comparative study on two types of 3S and P-loops digestive reconstruction after total gastrectomy for gastric...

To compare the clinical effect of 3S-type and P-loops digestive reconstruction after total gastrectomy for gastric cancer.

From February 2005 to February 2009, 85 cases underwent total gastrectomy in The First Affiliated Hospital of Henan University of Science and Technology. Two types of digestive reconstruction were performed with 3S-type jejunum(n=46) and P-loops Roux-en-Y esophagojejunostomy(n=39). The postoperative complications, nutrition index and the quality of life at half a year after surgery were comparatively analyzed.

Two types of digestive reconstruction had no statistical differences in operative time, postoperative complications and mortality(P>0.05). Compared with P-loops Roux-en-Y esophagojejunostomy at 6 months after operation, 3S-type jejunum had a lower incidence in dumping syndrome[4.3% (2/46) vs. 10.3% (4/39), P<0.05] and reflux esophagitis [10.8% (5/46) vs. 33.3% (13/39), P<0.05]. 3S-type jejunum was superior to P-loops Roux-en-Y esophagojejunostomy in serum total protein(55.7±3.1 g/L vs 50.3±5.1 g/L, P<0.05), albumin(36.5±3.6 g/L vs. 31.6±4.4 g/L, P<0.05), hemoglobin(120.2±13.4 g/L vs. 110.4±23.0 g/L, P<0.05), and nutritional assessment index(73.2±4.8 vs. 56.0±6.3, P<0.05).

Reconstruction of stomach with 3S-type jejunum may be an effective way to prevent reflux esophagitis and dumping syndrome, and to improve the nutritional status and the quality of life.