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Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: prospective randomized controlled trial
The American Journal of Surgery, 09/02/2011
Ishigami S et al. – Although authors' patient sample was small and patients who did not complete the follow–up survey were present, they could not identify any clinical difference between interposition of jejunum reconstruction (INT) and Roux–en–Y reconstruction (RY) after total gastrectomy 60 months after surgery. The safer and simpler RY method may be a more suitable reconstruction method than INT after total gastrectomy.
Methods- A total of 103 patients with gastric cancer were prospectively randomly divided into groups for RY (n = 51) or INT reconstruction (n = 52) after total gastrectomy.
- They were stratified by sex, age, institute, histology, and degree of lymph node dissection.
- Postoperatively, body mass index (BMI) and nutritional conditions were measured serially, and quality of life (QOL) and postoperative squalor scores were evaluated at 3, 12, and 60 months and compared between the 2 groups.
- After removing patients who did not complete the follow-up survey or censured cases, 24 patients in the RY group and 18 patients in the INT group were clinically available and their postoperative status was assessed.
- QOL scores were increased and complication scores were improved in the postoperative periods (P < .01).
- Postoperative BMI significantly deteriorated compared with preoperative BMI in each group.
- The postoperative QOL and complication scores at 60 months after surgery were significantly better than those at 3 months after surgery in each group (P < .01).
- However, there was no significant difference of QOL scores and postoperative complication scores between the 2 reconstruction groups.
- The nutritional condition in the INT group was nearly the same as that in the RY group.
