Objective：To explore the digestive tract reconstruction procedure after total gastrectomy.
Methods：The clinical efficacies of two types of digestive tract reconstruction procedures, P-type jejunal pouch Roux-en-Y esophagojejunostomy (PRY, n=120) and modified “P” jejunal interposition pouch reconstruction (mPJIP, n=122), were compared. The operative time, surgical complications and change of postoperative nutrition indexes were observed.
Results：There was no statistical difference (P＞0.05) in operation time between PRY and mPJIP group, which was (3.8±0.2) h and (3.6±0.1) h, respectively. The surgical complications and death of PRY group ［13 cases (10.8%), 4 cases (3.3%)］ were significantly higher than and those of mPJIP group ［9 cases (7.4%), 3 cases (2.5%)］ (both P＜0.05). The postoperative nutrition indexes alteration such as body weight, total protein and prognostic nutritional index in mPJIP group were significantly better than those of PRY group (all P＜0.05).
Conclusions：The mPJIP reconstruction can improve patient′s quality of life and reduce the postopertative complications and mortality of total gastrectomy. mPJIP is an ideal procedure for digestive tract reconstruction after total gastrectomy and therefore is recommended for use in clinical practice.