Usefulness of reconstruction with jejunal pouch in total gastrectomy for gastric cancer in early improvement of nutritional condition

Background: Roux-en-Y reconstruction with a jejunal pouch is a modified sta ndard procedure in total gastrectomy for gastric cancer. The aim of the cur rent study was to evaluate the usefulness of the reconstruction using a jej unal pouch in subsequent improvement of the nutritional condition of patien ts with gastric cancer after total gastrectomy. Methods: Sixteen patients with gastric cancer treated by total gastrectomy and reconstruction with simple Roux-en-Y from January 1993 to December 1996 and 14 patients treated by total gastrectomy and reconstruction with Roux- en-Y and jejunal pouch from January 1997 to December 1998 were investigated in regard to postoperative heartburn, changes in the bodyweight, and progn ostic nutritional index. Results: Postoperative heartburn occurred in 1 patient (7.1%) among patient s treated with Roux-en-Y and jejunal pouch and 3 (18.8%) among patients tre ated with simple Roux-en-Y; The body weight ratio at I year after operation in patients treated with Roux-en-Y and jejunal pouch (88.2% +/- 4.2%) was significantly higher than that in patients treated with simple Roux-en-Y (8 0.0% +/- 4.6%; P <0.01). The prognostic nutritional index ratios for patien ts treated with Roux-en-Y and jejunal pouch at I and 3 months after operati on were 93.9% +/- 9.1% and 101.7% +/- 11.0%, respectively, and were signifi cantly higher than that in patients treated with simple Roux-en-Y (86.2% +/ - 8.8% and 88.1% +/- 8.2%, P <0.05 and P <0.01, respectively). Conclusions: Reconstruction using a jejunal pouch in total gastrectomy is u seful for an early improvement of the nutritional condition of patients wit h gastric cancer. (C) 2001 Excerpta Medica, Inc. All rights reserved.