XIAO Shiming , JIANG Huaiwu , WU Chen , OU Rongce , CHEN Jin , XIAO Lin.
  • The Second Department of General Surgery, The Second Affiliated Hospital of Northern Sichuan Medical College, Mianyang 621000, Sichuan Province, ChinaCorresponding Author: JIANG Huai-wu, E-mail: jhuaiwu@yahoo.com.cn;
Stomach neoplasm; Subtotal gastrectomy; Digestive tract reconstruction; Jejunal interposition; Accommodation double digestive tract
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Objective 　To explore the optimal technique for digestive tract reconstruction of proximal gastrectomy.
Methods 　Fifty-nine patients who underwent proximal subtotal gastrectomy during June 2004 and January 2007 were analyzed retrospectively. All patients were divided into 2 groups according to the styles of reconstruction: one group with gastroesophagostomy (GE group) and the other with accommodation double tract digestive reconstruction of jejunal interposition (GIE group). The reconstruction of GIE group was to interposite a continuous 35 cm jejunum between the gastric stump and the oesophagus, which detail had been reported in our previous literature. The quality of life in 2 groups were evaluated and compared.
Results 　No patient died and there was no anastomotic leakage, dumping syndrome and moderate or severe anemia occurred during perioperative period. There was no significant difference of the following indexes of nutrition between 2 groups 1 month and 6 months after operation: the value of weight, RBC, Hb, Alb, PNI and the indexes versus the preoperative ones (P gt;0.05), for the exception of the indexes of RBC (P=0.006), Hb (P=0.001) in 1 month after operation versus the preoperative ones. The abdominal and the reflux esophagitis symptoms in GIE group were milder than those in GE group (P lt;0.001). The Visick scoring: most of the GIE group were gradeⅡ (74.2%), and grade Ⅲ (64.3%) in the GE group. There was no delay of the first time of adjuvant chemotherapy in GIE group (P gt;0.05), and the surgical time was (0.35±0.13) h more than that of GE group (P=0.01).
Conclusion 　The accommodation double tract digestive reconstruction of jejunal interposition for proximal subtotal gastrectomy may be safe and feasible by decreasing residual cancer cells and improving the quality of life of patients with proximal gastric carcinoma who underwent such surgical procedure.

Citation： XIAO Shiming,JIANG Huaiwu,WU Chen,OU Rongce,CHEN Jin,XIAO Lin.. Evaluation of Two Digestive Tract Reconstruction Procedures of Proximal Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(9): 682-685. doi: Copy