Kurita Nobuhiro, Shimada Mitsuo, Chikakiyo Motoya, Miyatani Tomohiko, Higashijima Jyun, Yoshikawa Kouzou, Nishioka Masanori, Iwata Takashi
Department of Surgery, University of Tokushima, Kuramoto 3-18-15, Tokushima 770-8503, Japan.
Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1851-4.
BACKGROUND/AIMS: To evaluate the efficacy of a jejunal pouch after a total gastrectomy with Roux-en Y reconstruction.
Thirty patients with gastric cancer who had a total gastrectomy as a radical operation and had no recurrence were enrolled in this study. The jejunal pouch was added to Roux-en Y reconstruction in 15 patients (J-pouch group) and was not added in the other 15 patients (Roux en-Y group). A questionnaire survey which consisted of dietary intake, postprandial abdominal complaints and body weight, blood examination (hemoglobin, total protein, albumin), were conducted. The 99mTc-DTPA with semi-liquid diet emptying test and the manometry in the jejunal pouch were evaluated in 12, 2 of the J-pouch group, respectively.
There were no significant differences between the two groups in the questionnaire survey and blood examination. The half emptying time (T1/2) of 99mTc-DTPA was over 60 minutes in 9 of the 12 J-pouch group. The manometric study did not reveal the effective contraction of the jejunal pouch. Bypass operation was necessary due to marked delay of emptying in the jejunal pouch for one patient in the J-pouch group.
The advantage of adding a jejunal pouch to Roux en-Y reconstruction was not proven in this study.
背景/目的：评估全胃切除术后行 Roux-en Y 重建时空肠袋的疗效。
30 例接受根治性全胃切除术且无复发的胃癌患者纳入本研究。15 例患者在 Roux-en Y 重建中增加了空肠袋（J 袋组），另外 15 例患者未增加空肠袋（Roux en-Y 组）。进行了一项问卷调查，内容包括饮食摄入、餐后腹部不适和体重、血液检查（血红蛋白、总蛋白、白蛋白）。J 袋组分别有 12 例和 2 例患者接受了 99mTc-DTPA 半流质饮食排空试验和空肠袋测压。
两组在问卷调查和血液检查方面无显著差异。J 袋组 12 例中有 9 例 99mTc-DTPA 的半排空时间（T1/2）超过 60 分钟。测压研究未显示空肠袋有有效收缩。J 袋组有 1 例患者因空肠袋排空明显延迟而需要进行旁路手术。
本研究未证实 Roux en-Y 重建中增加空肠袋的优势。
