AB83. Comparison of the quality of life and nutritional parameters after total gastrectomy with or without jejunal interposition
Xuewei Ding, Han Liang, Rupeng Zhang, Baogui Wang, Ning Liu, Yuan Pan, Qinghao Cui, Hongmin Liu, Xishan Hao
Objective: To investigate the optimal reconstruction technique after total gastrectomy.
Methods: A total of 204 patients with gastric cancer undergoing tatal gastrectomy in Tianjin Cancer Hosptital: group A (simple loop, n=54), group B (Roux-en-Y, n=79), group C (functional jejunal interposition, n=71), QOL, nutritional status 3 and 12 months after surgery, and perioperative complications were analyzed.
Results: There were no significant differences in perioperative complications (P>0.05). 3 and 12 months after operation, QOL (Visick index) was better in group C than that in groups A, B (P<0.05); the increase in weight gain, hemoglobin and total protein were better in group C than those in groups A, B (P<0.05). The prognostic nutrition index of the three groups were 44.98±4.95, 45.85±5.59, 51.74±5.49, 3 months after surgery; 46.19±6.18, 48.14±5.22, 53.70±5.83, 12 months after surgery; respectively. Group C was better than that in groups A, B (P<0.05). The early dumping syndrome was 5.6% (4/71) in group C, lower than group A 20.4% (11/54) and B 16.5% (13/79) (P<0.05), respectively. The incidences of reflux esophagitis, Roux-en-Y stasis syndrome in group C were 4.2% (3/71) and 5.6% (4/71), group A 18.5% (10/54) and 7.4% (4/54), group B 16.5% (13/79) and 17.7% (14/79), respectively, which were significantly lower than those in other groups(P<0.05).
Conclusions: Functional jejunal interposition is associated with improved nutritional condition and quality of life, and less perioperative complications. It means that passage of duodenum preserved is a reasonable reconstruction method after total gastrectomy.
Keywords: Stomach neoplasms; total gastrectomy; digestive tract reconstruction
