胃全摘術における空腸ｐｏｕｃｈ　Ｒｏｕｘ‐Ｙ再建法とＲｏｕｘ‐Ｙ再建法との比較検討

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  • Comparative studies between jejunal pouch Roux-Y and simple Roux-Y reconstructions after total gastrectomy.

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To determine the optimum reconstruction procedure after total gastrectomy, the results of two different methods, jejunal pouch Roux-Y and simple Roux-Y reconstructions, were compared retrospectively. Jejunal pouch Roux-Y (PRY) was performed in 17 patients and simple Roux-Y (RY) in 18. The operation time, postoperative complications, postprandial symptoms, food intake per meal and body weight were evaluated. The operation time was 350 minutes in the PRY group and 276 minutes in the RY group, showing a significant prolongation of the operation time in the PRY group. When patients undergone No.16 lymph node dissection were excluded, however, no significant difference in the operation time was revealed between the two groups, 316 versus 272 minutes respectively. There were no significant differences in the postoperative stay and postoperative complications between the two groups. Concerning postprandial symptoms, none of the patients developed dumping in the PRY group, while two patients did in the RY group. There was a tendency toward a lower incidence of heartburn in the PRY group than in the RY group. The PRY group showed a significantly lower incidence of dysphagia than that in the RY group. The PRY group showed a greater food intake per meal than the RY group and significantly greater weight recovery than the JI group (p<0.05). We think that jejunal pouch Roux-Y reconstruction is the standard procedure after total gastrectomy in terms of less postoperative complaints, favorable postoperative weight recovery, and minimal complications.

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