Abstract:Objective To explore the ideal mode of degestive tract reconstruction after total gastrectomy.
Methods One hundred and sixteen gastric cancer patients, who underwent one of two reconstruction procedures between Jan 1996 and May 2006, were retrospectively evaluated with regard to their digestive symptoms and nutritional status. The two procedures were double Braun anastomosis (double Braun) and PRouxenY reconstruction (PRy).
Results Follow up of the 2 groups, at one year after operation, showed the frequency of early satiety, reflux esophagitis and dumping syndrome in the double Braun group was 1(1.69%),3(5.08%), and 2(3.39%) cases, respectively, and in PRy group was 13(22.81%), 10(17.54%), and 8(14.04%) cases, respectively.Compared with PRy group, the frequency of reflux esophagitis in double Braun group was less (P＜0.05); and in doubl Braun group, patients had better food intake and lower rate of early satiety(P＜0.01), and rate of dumping syndrome was less (P＜0.05). But no difference was found in nutritional status(body weight and serum nutrition parameters) between the two groups(P＞0.05).
Conclusions Compared to PRy group, the postoperative quality of life was better and the subjective symptoms were fewer in patients of double Braun group. So authors considerate that after total gastrectomy double Braun anastomosis is a relatively ideal alimentary tract reconstruction method. Double Braun anastomosis is recommended as the method of choice for patients undergoing total gastrectomy.