[Effects of total gastrectomy on the nutritional status]

In this study, we have analyzed a series of 88 patients who underwent total gastrectomy followed by two different reconstructive procedures, Roux-en-Y jejunal interposition (57%) and interposition of a jejunal limb between the oesophagus and the duodenum (38%) (Henley procedure). We examined diet, intestinal transit, symptoms of dumping syndrome and body weight curves. Patients with Roux-en-Y reconstruction presented post-prandial sweating more often (48%) than patients with the Henley procedure (21%). Forty percent patients with Roux-en-Y reconstruction suffered post-prandial nausea whereas this finding was not associated with patients after the Henley procedure. The reconstructive method has to be chosen considering the age and general condition of the patient, stage of the neoplasia and its curability. We currently favor Roux-en-Y esophagojejunostomy. However, in selected patients the Henley procedure may prove useful in order to prevent reflux and dumping symptoms.