Clinical Analysis of Jejunal Pouch Reconstruction after Total Gastrectomy for Gastric Cancer

ABSTRACT

PURPOSE: The use of a total gastrectomy for gastric cancer has increased with the increasing incidence of gastric cancer involving the proximal stomach. Various types of reconstruction have been introduced to reduce the associated complications, such as reflux esophagitis and malnutrition, following a total gastrectomy. METHODS: Between January 2002 and September 2003, the incidence of reflux esophagitis and the nutritional status, according to three types of reconstructive, were analyzed in 67 patients who underwent a total gastrectomy for gastric cancer involving the proximal stomach. The three types of reconstruction were a Lygidakis pouch (LY-26 cases), a Hunt-Laurence pouch (HR-25 cases) and an Aboral pouch (AB-16 cases). RESULTS: Twenty three (88%), 21 (84%) and 10 (62%) patients complained of reflux esophagitis symptoms following the Lygidakis pouch, Hunt-Laurence pouch and Aboral pouch procedures, respectively. Less reflux esophagitis complications were observed following the Aboral pouch than with the other two procedures (P=0.03). No significant differences were found in the levels of serum hemoglobin, cholesterol, total protein and albumin for nutritional status between the three types. CONCLUSIONS: The Aboral pouch procedure was superior to the other two reconstructive procedures with respect to reflux esophagitis.