[Comparison of different alimentary reconstructions after total gastrectomy for cancer].

OBJECTIVE

To study the optimum reconstruction after total gastrectomy for malignant disease, especially the necessity of gastric substitute and duodenal passage.

METHODS

Among 75 patients having total gastrectomy, five kinds of reconstruction were used: Braun, modified Braun (mBraun) I, II, III, and antigrade jejunal interposition (AJI). Postoperative complaints, body weight, food intake, serum nutritional parameters, complete blood count, half-emptying time of the gastric substitute, PNI, Visick index were evaluated.

RESULTS

As compared with Braun group, the mBraun I and II groups showed less reflux esophagitis, higher nutritional parameters and PNI, while the operation time was similar. As compared with mBraun I and II groups, mBraun III and AJI groups showed better body weight, higher nutritional parameters, and PNI.

CONCLUSIONS

It is essential to construct a gastric substitute and maintain the alimentary tract flowing through the duodenum after total gastrectomy for cancer, and the AJI may be a better choice in the operation of gastrectomy.