Impacts of jejunal P pouch reconstruction and functional jejunal interposition in reconstructed duodenal food passage after total gastrectomy on long-term nutritional status

Objective To compare the long-term nutritional status and quality of life after jejunal P pouch reconstruction and functional jejunal interposition (FJI) in reconstructed duodenal food passage after total gastrectomy.Methods Of 50 patients with gastric cancer who received total gastrectomy in Donghua Hospital between January 2003 and June 2011,27 received jejunal P pouch reconstruction and 23 underwent FJI.All the patients were given total parenteral nutrition from the first to the seventh postoperative day,and the perioperative complications were observed.The body weight,serum total protein,serum albumin,and hemoglobin were measured 6 and 12 months after surgery,and the nutritional assessment index (NAI) was calculated.Results No serious complications occurred in any of the cases,and no surgery-or chemotherapy-related death was noted.Six months after the surgery,the body weight loss [(3.67 ± 0.91) kg vs.(3.44 ± 0.52) kg,P =0.28],serum total protein [(52.62 ± 1.67) g/L vs.(53.22 ± 1.24) g/L,P =0.16],serum albumin[(31.26± 1.29) g/L vs.(30.70 ±2.41) g/L,P =0.32],hemoglobin [(118.01 ±5.96) g/L vs.(117.83 ±6.72) g/L,P =0.92],NAI (P =0.39),and reflux esophagitis incidence (11.1％ vs.13.0％,P =1.00) showed no significant difference between these 2 groups.Twelve months after the surgery,the body weight loss [(2.71 ±0.45) kg vs.(2.74 ±0.42) kg,P =0.77],serum total protein [(53.93 ±1.66) g/Lvs.(53.34 ± 1.84) g/L,P =0.24],serum albumin [(32.60 ± 1.42) g/L vs.(30.76 ±2.10) g/L,P=0.23],hemoglobin [(124.18 ±6.56) g/Lvs.(119.99 ±6.13) g/L,P=0.16],NAI(P =0.43),and reflux esophagitis incidence (7.4％ vs.8.7％,P =1.00) were also not significantly different between the 2 groups.Conclusion The impacts on long-term nutritional status and quality of life are similar between jejunal P pouch reconstruction and FJI in reconstructed duodenal food passage after total gastrectomy. Key words: Gastric neoplasm ;  Gastrectomy ;  Digestive tract reconstruction ;  Jejunal interposition reconstruction;  Nutritional status