Application of RouxenY Gastrojejunostomy after Proximal Gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Yuan ¹ , LI Shaosen ¹ , ZHANG Haitian ¹ , LU Yunfei ¹ , LU Lisheng ¹ , LAN Yuyan ²

Department of Gastrointestinal Surgery, The First Affiliated Hospital, Guangxi University of Medical Science, Nanning 530027, China;

Corresponding author：

Keywords：

GastrectomyRouxenY gastrojejunostomyReflux esophagitis

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ObjectiveTo prospectively study the effect of preventing postoperative reflux esophagitis with esophagogastrostomy and RouxenY gastrojejunostomy after proximal subtotal gastrectomy.MethodsTwentysix cases of carcinoma of the gastric fundus and cardia were allocated randomly to 2 groups (the control group with 12 cases and the experimental group with 14 cases) according to odd or even number of the admission number.After proximal subtotal gastrectomy and esophagogastrostomy, the control group underwent pyloroplasty while the experimental group with pyloruspreserving RouxenY gastrojejunostomy.The inflammatory reaction of the tissue obtained at the esophagogastric junction using a fiber gastroscope was observed after half year of postoperative followup in the two groups.An examination of gastric emptying of a radionuclidelabeled test meal were performed.According to the Visick score of followup data,the effects of operation were evaluated.The 5year survival rate was also evaluated.ResultsThe postoperative gastrointestinal symptoms in the experimental group were slighter than those in the control group.The examination of gastric emptying of a radionuclidelabeled test meal showed that the gastric emptying time of a half dose,gastric remains rates of radionuclide after 10 min and 60 min in the experimental group were similar to those in the control healthy people group.But in the control group,the gastric emptying time of a half dose delayed,and the gastric remains rate of radionuclide after 10 min and 60 min were higher than the other groups.The biopsy study of the esophagogastric junction showed that the inflammatory reaction in the experimental group was slighter than that in the control group.There was no significant difference between the two groups in the survival rate.ConclusionFor patients with carcinoma of the gastric fundus and cardia, after proximal subtotal gastrectomy and esophagogastrostomy,compared with pyloroplasty,pyloruspreserving RouxenY gastrojejunostomy can decrease the reflux esophagitis,and relieve the postoperative gastrointestinal symptoms.

Citation： HUANG Yuan,LI Shaosen,ZHANG Haitian,LU Yunfei,LU Lisheng,LAN Yuyan. Application of RouxenY Gastrojejunostomy after Proximal Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(5): 477-479. doi: Copy

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1. Harrison LE, Karpeh MS, Brennan MF. Extended lymphadenectomy is associated with a survival benefit for nodenegative gastric cancer [J]. J Gastrointest Surg, 1998; 2(2)∶126.
2. Oka M, Yamamoto K, Nakamura M, et al. Reconstruction after proximal gastrectomy using a stapled Ushaped jejunal pouch [J]. J Am Coll Surg, 1998; 186(5)∶601.
3. 陈峻青，夏志平主编. 胃肠癌根治手术学 [M]. 第1版. 北京：人民卫生出版社， 1998∶38～46.
4. Uyama I, Sugioka A, Fujita J, et al. Completely laparoscopic proximal gastrectomy with jejunal interposition and lymphadenectomy [J]. J Am Coll Surg, 2000; 191(1)∶114.
5. 陈文虎，蒋勇，周允中. 19例贲门癌术后食管腔内24小时PH值监测结果分析 [J]. 中华胸心血管外科杂志， 1998； 2（14）∶18.
6. 陈峻青. 正确选择胃癌切除的重建术 [J]. 中华胃肠外科杂志， 2001； 4（1）∶5.
7. 高枫，黄顺荣. 对胃切除术后重建术式的看法 [J]. 中国普外基础与临床杂志， 2001； 8（3）∶191.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of RouxenY Gastrojejunostomy after Proximal Gastrectomy

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