Clinical Study of Modified Orr Roux-en-Y Type Digestive Tract Reconstruction after Total Gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Libo , LI Yongchao , FENG Ye , SHU Zhenbo , DING Dayong , JIN Yinzhi , ZHAO Jisheng , ZHENG Zelin

Department of Gastrointestinal Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China;

Corresponding author：

Keywords：

Gastric cancer; Total gastrectomy; Digestive tract reconstruction

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Objective To evaluate the clinical application of modified Orr Roux-en-Y type digestive tract reconstruction. Methods Thirty-eight patients with gastric cancer were randomly classified into modified group （accepted modified Orr Roux-en-Y type digestive tract reconstruction, 18 cases） and ρ group （accepted ρ type esophagojejunostomy, 20 cases） according to the date of operation. Operative time, blood loss in operation, complications after operation, emptying time of pouch, and change of body weight before and 3 months after operation were compared between two groups. Results Compared with the ρ group 〔(283±35) min〕, the operative time of modified group 〔(229±18) min〕 was significantly shorter （P lt;0.05）. The holo-empyting time of pouch in modified group 〔(35.7±4.9) min〕 was longer than that in ρ group 〔(3.0±0.5) min〕, P lt;0.01. Blood loss in operation, complications after operation, and the body weight change had no statistical difference between two groups （P gt;0.05）. Conclusion Modified Orr Roux-en-Y type reconstruction with a pouch function is useful in clinical application， which is not only easy to operate, but also can reduce the operative time and the complications.

Citation： SUN Libo,LI Yongchao,FENG Ye,SHU Zhenbo,DING Dayong,JIN Yinzhi,ZHAO Jisheng,ZHENG Zelin. Clinical Study of Modified Orr Roux-en-Y Type Digestive Tract Reconstruction after Total Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(12): 917-919. doi: Copy

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19.	伍韶斌, 陈志康, 陈晋湘, 等. 胃癌全胃切除术后消化道重建方式的选择 [Ｊ]. 中国普通外科杂志, 2006; 15(10)∶ 766.
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1. 詹文华. 循证医学和全胃切除后消化道重建 [Ｊ]. 中国实用外科杂志, 2004; 24(9)∶ 514.
2. 季加孚. 全胃切除后的消化道重建 [Ｊ]. 中国实用外科杂志, 2004; 24(9)∶ 516.
3. Lehnert T, Buhl K. Techniques of reconstruction after total gastrectomy for cancer [Ｊ]. Br J Surg, 2004; 91(5)∶ 528.
4. 朱正纲. 全胃切除与消化道重建术在胃癌治疗中的临床意义 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1)∶15.
5. 肖仕明, 姜淮芜, 陈进, 等. 全胃切除调节型双通道间置空肠消化道重建 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(1)∶23.
6. Ogoshi K, Okamoto Y, Nabeshima K, et al. Focus on the conditions and resection and reconstruction in gastric cancer. What extent of resection and what kind of reconstruction provided the best outcome for gastric caner patients? [Ｊ]. Digestion, 2005; 71(4)∶ 213.
7. 刘作金, 刘长安, 龚建平, 等. 间置空肠代胃与Roux-en-Y吻合法消化道重建对病人生存质量影响的研究 [Ｊ]. 中国实用外科杂志, 2005; 25(7)∶420.
8. 夏焱, 姜波健, 韩肖华, 等. 胃癌患者全胃切除术后空肠代胃消化道重建术式的对比研究 [Ｊ]. 中华胃肠外科杂志, 2004; 7(1)∶ 24.
9. Nakane Y, Michiura T, Inoue K, et al. A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition? [Ｊ]. Hepatogastroenterology, 2001; 48(39)∶ 903.
10. Mochiki E, Kamiyama Y, Aihara R, et al. Postoperative functional evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer [Ｊ]. Am J Surg, 2004; 187(6)∶ 728.
11. Nozoe T, Anai H, Sugimachi K. Usefulness of reconstruction with jejunal pouch in total gastrectomy for gastric cancer in early improvement of nutritional condition [Ｊ]. Am J Surg, 2001; 181(3)∶ 274.
12. 卫洪波, 魏波, 郑宗珩, 等. 全胃切除后三种消化道重建术式的比较研究 [Ｊ]. 中华胃肠外科杂志, 2006; 9(4)∶ 301.
13. Kono K, Iizuka H, Sekikawa T, et al. Improved quality of life with jejunal pouch reconstruction after total gastrectomy [Ｊ]. Am J Surg, 2003; 185(2)∶150.
14. Adachi S, Inagawa S, Enomoto T, et al. Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures [Ｊ]. Gastric Cancer, 2003; 6(1)∶ 24.
15. 黄祥成, 巴明成, 卿三华, 等. 全胃切除后三种消化道重建术式对生活质量的影响 [Ｊ]. 中华普通外科杂志, 2005; 20(10)∶ 654.
16. 支珍. 全胃切除术后消化道重建两种术式的临床观察 [Ｊ]. 中国普通外科杂志, 2007; 16(9)∶ 875.
17. 叶再元, 张勤, 余建法, 等. 连续性空肠间置在胃次全切除术消化道重建中的应用研究 [Ｊ]. 中华胃肠外科杂志, 2006; 9(3)∶ 238.
18. Fein M, Fuchs KH, Thalheimer A, et al. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a randomized trial [Ｊ]. Ann Surg, 2008; 247(5)∶ 759.
19. 伍韶斌, 陈志康, 陈晋湘, 等. 胃癌全胃切除术后消化道重建方式的选择 [Ｊ]. 中国普通外科杂志, 2006; 15(10)∶ 766.
20. Kalmár K, Cseke L, Zámbó K, et al. Comparison of quality of life and nutritional parameters after total gastrectomy and a new type of pouch construction with simple Roux-en-Y reconstruction: preliminary results of a prospective, randomized, controlled study [Ｊ]. Dig Dis Sci, 2001; 46(8)∶1791.
21. 曾玉剑，程中，周总光. 全胃切除后消化道重建的现状 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(5)∶ 383.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Study of Modified Orr Roux-en-Y Type Digestive Tract Reconstruction after Total Gastrectomy

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