Objective To investigate the optimum reconstruction after total gastrectomy for malignant disease,especially the necessity of gastric substitute and duodenal passage.Methods Among the 459 total gastrectomy cases,6 ki...Objective To investigate the optimum reconstruction after total gastrectomy for malignant disease,especially the necessity of gastric substitute and duodenal passage.Methods Among the 459 total gastrectomy cases,6 kinds of reconstructions had been used,including Braun,modified Braun I(mBraun I),modified Braun Ⅱ（mBraun Ⅱ),Roux-en-Y,“P jejunal interposition(PJI)and functional jejunal interposition(FJI).Postoperative complains,body weight,food intake,serum nutritional paraments,complete blood cout,half-emptying time of the gastric substitute,PNI,Visick index were evaluated one year after r surgery.Results As compared with Braun group,the mBraun I,Ⅱ and Roux-en-Y groups which had some kinds of gastric substitute showed less reflux esophagitis and higher serum total protein(P<0.01).As compared with mBraun I,Ⅱ,Roux-en-Y,PJI and FJI groups which had duodenal passage showed better body weight,higher nutritional paraments and PNI(P<0.05).Conclusion It is essential to construct a gastric substitute and maintain the food chyme flowing through the duodenum after total gastrectomy,and the FJI is a better choice in this study.展开更多
文摘Objective To investigate the optimum reconstruction after total gastrectomy for malignant disease,especially the necessity of gastric substitute and duodenal passage.Methods Among the 459 total gastrectomy cases,6 kinds of reconstructions had been used,including Braun,modified Braun I(mBraun I),modified Braun Ⅱ（mBraun Ⅱ),Roux-en-Y,“P jejunal interposition(PJI)and functional jejunal interposition(FJI).Postoperative complains,body weight,food intake,serum nutritional paraments,complete blood cout,half-emptying time of the gastric substitute,PNI,Visick index were evaluated one year after r surgery.Results As compared with Braun group,the mBraun I,Ⅱ and Roux-en-Y groups which had some kinds of gastric substitute showed less reflux esophagitis and higher serum total protein(P<0.01).As compared with mBraun I,Ⅱ,Roux-en-Y,PJI and FJI groups which had duodenal passage showed better body weight,higher nutritional paraments and PNI(P<0.05).Conclusion It is essential to construct a gastric substitute and maintain the food chyme flowing through the duodenum after total gastrectomy,and the FJI is a better choice in this study.
