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KMID : 0365719960120010023
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Journal of Pusan Surgical Society
1996 Volume.12 No. 1 p.23 ~ p.29
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Clinical Considerations about Bowel Reconstruction after Total Gastrectomy
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Abstract
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Postprandial symptoms of varying degrees and long-term nutritional derangements are well-known consequences of total gastrectomy. Nutritional parameters, postprandial symptoms, performance status, emptying time of the gastric substitute, and
endoscopic
finding were assessed in 20 patients who were free of tumors 12 to 41 months(mean = 25 months) after total gastrectomy with Roux-en-Y esophagojejunostomy (RNY, n =12) or with jejunal pouch interposition (JPI, n =8). There were no significant
differences
between the two groups with respect to age, sex, interval after operation, and premorbid body mass index (BMI = weight/height 2).
@ES The results are summarized as follows :
@EN 1) The serum albumin (g/dl) and cholesterol (mg/dl) were 4.2±0.4/181.3±30.4 in RNY and 4.1±0.2/204.1±51.4 in JPI.
2) Body weigh increase (kg, present body weight-lowest body weight) was 4.5±4.9 in RNY and 2.5±51. in JPI.
3) The rate of body weight regain (%) to premorbid weight was 90.4±6 in RNY and 84.3±14.3 in JPI.
4) The rate of present BMI (body mass index) to premorbid BMI (%) was 904±6.3 RNY and 88.4±8.5 in JPI.
5) All nutritional parameters have no statistical significance (p>0.05).
6) Performance status and symptomatic assessment by Cuschieri' s scoring system have no statistical significance (p>0.05).
7) Emptying time of gastric substitute was prolonged in JPI.
8) The incidence of reflux esophagitis assessed by endoscopy did not have any significant difference between two groups.
Therefore, although the jejunal pouch interposition seems to be more physiologic than RNY, it was not better than RNY in terms of all nutritional parameters and symptomatic assessment.
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KEYWORD
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