| Objective:More than 70 alimentary reconstruction procedures after total gastrectomy have been proposed to reduce the postoperative syndromes such as dumping syndrome, reflux esophagitis, and malnutrition. However, the optimal alimentary reconstruction method is still a matter of debate. The aim of the current study was to investigate the rationality of different alimentary tract reconstruction methods after total gastrectomy for gastric malignancy.Methods:Two types of digestive reconstruction methods were performed after total gastrectomy in 46 cases of gastric malignancy from December 2005 to December 2008, including Orr-type Roux-en-Y reconstruction and schloffer reconstruction methods. According to reconstruction type, there were divided into two groups:A group (22 cases), esophageal-type jejunal loop anastomosis, that is schloffer anastomosis; B group (24 cases), esophageal jejunal Roux-en-y anastomosis. B group is divided into two groups, that is B1 and B2, by the distance between the two anastomosis whether longer then 40cm. Through re-admitted to hospital, out-patient review and telephone follow-up, etc. compared with the body weight change, food intake improved, the symptoms of reflux esophagitis, Then observed clinical efficacy. Results:There were no significant differences between the two methods in postoperative food intake and weight change. However, the incidences of reflux esophagitis after the gastric reconstruction with the schloffer-type method at half years were significantly higher than that with the Orr-type Roux-en-Y (p<0.01)Conclusion:Orr-type Roux-en-Y reconstruction method can reduce the incidences of reflux esophagitis, Therefore, Orr-type Roux-en-Y reconstruction can be recommended as an adoptable method of digestive reconstruction after total gastrectomy for gastric cancer. The distance between the two anastomotic must be about 40cm. |
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