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Chirurgia 2010 October;23(5):155-9

language: English

Prospective randomized trial to evaluate the quality of life after proximal gastrectomy for gastric cancer: jejunal pouch interposition versus double-tract reconstruction

Ikeguchi M., Kuroda H., Matsunaga T., Saito H., Tatebe S.

Department of Surgery, Division of Surgical Oncology, Faculty of Medicine, Tottori University, Yonago, Japan


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Aim. Proximal gastrectomy (PG) was introduced for patients with early gastric cancer in the upper third of the stomach to preserve pyloric function of the residual stomach. We compared two reconstruction methods, jejunal interposition (JPI) with the double-tract (DT) method.
Methods. A prospective, randomized study was performed between 2005 and 2007 in 18 patients receiving JPI (n = 9) or DT reconstruction (n = 9). Patients were followed until the end of 2009. Subjective global assessment, objective data assessment, and endoscopy findings of the remnant stomach were compared.
Results. Operation duration, number of dissected lymph nodes, and postoperative hospital stay were similar in both groups. Food intake disturbance was frequently found in the DT group. Patients’ body weights recovered better after JPI than after DT reconstruction at 2 years postoperatively. Blood lymphocyte counts remained low in the DT group even after 2 years, in contrast to the JPI group whose counts recovered after 6 months, and continued to increase. Endoscopy showed a similar incidence of postoperative esophagitis and gastritis in both groups. However, food residue in the pouch was frequently observed after JPI (8/9, 88.9%).
Conclusions. JPI is safe and is associated with better nutritional status compared with DT reconstruction.

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