The application of FJI and its comparison with different alimentary reconstructions after total gastrectomy for cancer
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To investigate the optimum reconstruction after total gastrectomy for malignant disease, especially the necessity of gastric substitute and duodenal passage.
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 count, half-emptying time of the gastric substitute, PNI, Visick index were evaluated one year after surgery.
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).
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.
Key wordsgastric cancer total gastrectomy digestive tract reconstruction
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