|Budget Amount *help
¥3,400,000 (Direct Cost : ¥3,400,000)
Fiscal Year 1991 : ¥300,000 (Direct Cost : ¥300,000)
Fiscal Year 1990 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1989 : ¥2,300,000 (Direct Cost : ¥2,300,000)
Gastric replacement by various enteric reservoirs is used to improve nutrition after total gastrectomy. The effect is, however, uncertain since no prospective, randomized studies are available.
In Japan, as well as many other countries, the Roux-Y procedure, although not a physiological route, seems to be the most preferred reconstruction because it is relatively simple to carry out and prevents reflux esophagitis. With regard to dietary i13EA\ : ntake and nutrition, however, this procedure is not as satisfactory.
To determine which reconstruction after total gastrectomy would be the best for the patients, a randomized controlled trial was undertaken to compare the usefulness of the following 3 reconstructions ; somple Roux-Y (RY), pouch and Roux-Y (PR), and pouch and interposition (PI). A jejunal pouch was made by using GIA autosuture and measured about 20 cm in length.
Between 1988.11 and 1993.3, thirty patients who underwent total gastrectomy with curative resection were investigated for this study. Among them, the number of patients following more than 6 months without recurrence was 8, 8, and 5, respectively.13EA\ : Subjects were evaluated regarding food intake, body weight, postprandial symptoms, serum nutritional parameters, and emptying time of the gastric substitute.
From our results, PR reconstruction was the most useful in improving the postoperative quality of life.