The Comparison Between Two Reconstructions Of Alimentary Tract After Total Gastrectomy

Objective Since Schlatter completed the first operation of total gastrectomy and reconstruction of alimentary tract in 1897,the scholars have researched tens of alim-entary resconstructions. They kept developing and improving the res-constructions and tried to find one which would meet the needs of digestion and make the life better.Till nowadays, many alimentary restouctions have been given up because of the unphysiologic, complications or complex operations, except the Roux-en-Y, P type esophagojejunostomy,modified loop esophagojejunostomy and jejunal inter-position.In this thesis,we evaluate the P type esophagojejunostomy and modified loop esophagojejunostomy by compairing the digestive function of patients after operation.the nutrition indexes consist of weight,total protein,albumin and hemoglobin. The index of quality of life (QOL) consists of the complication of dumping syndrome and reflux esophagitis. We try to find one reasonable restruction.Methods From Jan 2006 to Jan 2009,two kinds of alimentary tract reconstruction were performed in 48 cases with total gastrectomy.twenty two cases with modified loop esophagojejunostomy (modified group) and 26 cawes with P type esophagojejunostomy (P group).we compared the nutrition conditions and complications of the two group of patients 6 months after operation and estimated the effect of the reconstructions.Results With 5 cases misinvestigated,the nutrition conditions of the other patients were much better after operation(P<0.01).meanwhile,the nutrition conditions of the modified group were better than that of the P group(P<0.01).8 cases of P group (35%) and 1 case of modified group (5%) had dumping syndrome.9 cases of P group (39%) and 2 cases of modified group (10%) had reflux esophagitis.significant differences existed in complications between the two groups(P <0.01). There was no one case with anastomotic leakage.Conclusions Modified jejunal loop possesses simple manipulation,agood postoperarive nutrition conditions and a high quality of life.It is one of desirable operation manner in the alimentary tract reconstruction after total gastrectomy.