Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
Am J Surg. 2012 Aug;204(2):203-9. doi: 10.1016/j.amjsurg.2011.09.035.
Proximal gastrectomy with jejunal pouch interposition (JPI) reconstruction has been advocated as a function-preserving surgery in patients with early gastric cancer located in the upper third of the stomach.
This study clinically investigated 22 patients who underwent JPI reconstruction and 22 patients who underwent Roux-en-Y (RY) reconstruction after total gastrectomy for stage IA/IB gastric cancer. Patients in the 2 groups were compared to evaluate the short- and long-term postoperative outcomes.
Morbidity and nutritional parameters were no different between the 2 groups. Although postoperative food intake volume was significantly superior in JPI patients than in RY patients 1 year postsurgery, the change in body weight was equal. JPI patients outperformed RY patients with a better quality of life (QOL) at 1 year postgastrectomy. However, 5 years after the surgery, both groups had a similar QOL except for fatigue.
JPI reconstruction leads to better outcomes including QOL than RY reconstruction in the short term. However, this short-term positive impact of JPI decreases over time.
对于位于胃上部的早期胃癌患者,提倡施行保留功能的近端胃切除术和空肠袢间置术(JPI)重建。
本研究对 22 例行 JPI 重建和 22 例行全胃切除后 Roux-en-Y(RY)重建的 IA/IB 期胃癌患者进行了临床研究。比较两组患者的短期和长期术后结果。
两组患者的发病率和营养参数无差异。尽管 JPI 组患者术后 1 年的食物摄入量明显优于 RY 组,但体重变化相同。与 RY 组相比,JPI 组患者在胃切除术后 1 年的生活质量(QOL)更好。然而,手术后 5 年,两组除疲劳外 QOL 相似。
在短期内,JPI 重建比 RY 重建导致更好的结果,包括 QOL。然而,JPI 的这种短期积极影响会随着时间的推移而减弱。