Comparative study on two types of 3Sand P-loops digestive reconstruction after total gastrectomy for gastric cancer

/Feng Xiaoshan

(冯笑山，Dept Oncol Surg，1st Affil Hosp Henan Univ Sci Technol，Henan Luoyang 471003)…∥Chin J Gastrointest Surg.-2011，14(8).-879～881

ObjectiveTo compare the clinical effect of 3S-type and P-loops digestive reconstruction after total gastrectomy for gastric cancer.MethodsFrom Februray 2005 to Februray 2009，85 cases underwent total gastrectomy in The First Affiliated Hospital of Henan University of Science and Technology.Two types of digestive reconstruction were performed with 3S-type jejunum(n=46)and P-loops Roux-en-Y esophagojejunostomy(n=39).The postoperative complications，nutrition index and the quality of life at half a year after surgery were comparatively analyzed.ResultsTwo types of digestive reconstruction had no statistical differences in operative time，postoperative complications and mortality(P ＞0.05).Compared with P-loops Roux-en-Y esophagojejunostomy at 6 months after operation，3S-type jejunum had a lower incidence in dumping syndrome 4.3%(2/46)vs.10.3%(4/39)，P ＜ 0.05］and reflux esophagitis 10.8%(5/46)vs.33.3%(13/39)，P ＜ 0.05.3S-type jejunum was superior to P-loops Roux-en-Y esophagojejunostomy in serum total protein(55.7 ± 3.1 g/L vs 50.3 ±5.1 g/L，P ＜ 0.05)，albumin(36.5 ± 3.6 g/L vs.31.6 ± 4.4 g/L，P ＜ 0.05)，hemoglobin(120.2 ±13.4 g/L vs.110.4 ± 23.0 g/L，P ＜ 0.05)，and nutritional assessment index(73.2 ±4.8 vs.56.0 ±6.3，P ＜0.05).ConclusionReconstruction of stomach with 3S-type jejunum may be an effective way to prevent reflux esophagitis and dumping syndrome，and to improve the nutritional status and the quality of life.10 refs，1 tab.