Evaluation of J-pouch reconstruction after total gastrectomy: rho-double tract vs. J-pouch double tract

Objective: Various enteric reservoirs have been advocated to improve the qu ality of life after total gastrectomy. We evaluated the advantages of pouch reconstruction compared with traditional p-double tract reconstruction. De sign: Prospective randomized study. Setting: Second Department of Surgery, Hyogo College of Medicine, Japan. Subjects: Forty patients who underwent to tal gastrectomy for cancer of the stomach were studied. Intervention: Forty patients were randomly divided into two groups: 20 patients received rho - double tract reconstruction (RDT group), and 20 underwent J-pouch double tr act reconstruction (PDT group) group. Main Outcome Measures: We compared th e body weight, serum nutritional parameters, reflux score, scintigraphic es ophageal reflux, food intake, and emptying time of the J-pouch or rho -limb between the two groups. Results: No difference was noted between the two g roups with regard to body weight, but food intake tended to be higher in th e PDT group than in the RDT group. Total protein and albumin levels were hi gher in the PDT group than in the RDT group, while scintigraphic reflux was significantly less prominent in the PDT group. Conclusions: J-pouch recons truction was superior with respect to protein metabolism, food intake and r eduction of reflux esophagitis compared with the traditional RDT method. Ho wever, use of pouch reconstruction did not improve postoperative weight gai n. Copyright (C) 2000 S. Karger AG. Basel.