J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1327KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 98(6): 532-536, 1997

Feature topic

JEJUNAL POUCH AND INTERPOSITION RECONSTRUCTION AFTER A TOTAL GASTRECTOMY FOR CANCER

2nd Department of Surgery, Kansai Medical University, Moriguchi, Japan

Yasushi Nakane, Keiji Akehira, Mutuya Sato, Syunichiro Okumura, Keigo Yamamichi, Shigeo Okamura, Kohsiro Hioki

The authors modified the operative procedures used in pouch and interposition (PI) reconstruction in an attempt to improve the surgical results after a total gastrectomy, because a randomized controlled trial had revealed that the clinical assessment of PI was quite poor, even though it is a physiological route. In most of the treated patients, the gastric emptying test revealed delayed emptying, and an X-ray video film showed folding and twisting of the jejunal conduit between the pouch and duodenum, which disturbed the transmission of the nutrition. Modified PI (m-PI) was performed by decreasing the length of the jejunal conduit and widening the jejunal pedicle to preserve the blood and nerve supply. The m-PI group showed alower incidence of symptoms, a greater food intake, and a greater weight recovery than the PI group. The gastric ernptying test also revealed an acceptable degree of emptying. We conclude that the m-PI reconstruction is more useful for improving the postoperative quality of life than the previosly used method of PI reconstruction.

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