Abstract: Objective:To investigate the short term safety and efficacy of Roux-en-Y anastomosis combined with pouch digestive tract reconstruction after total gastrectomy.
Methods:The clinical data of 7 patients with adenocarcinoma of the esophagogastric junction and 3 patients with gastric cancer who were admitted to the West China Hospital from July 2013 to November 2013 were retrospectively analyzed. All the patients received Roux-en-Y anastomosis and pouch digestive tract reconstruction following total gastrectomy+D₂ lymphadenectomy. The follow up was performed through out patient examination or phone call till November 2013. The operation time, intraoperative blood loss, duration of postoperative hospital stay, incidence of postoperative complications and mortality were analyzed.
Results:Transabdominal approach was adopted in 5 patients and transhiatal approach was adopted in the other 5 patients. The operation time, volume of blood loss and duration of postoperative hospital stay were (266±23)minutes, (143±40)mL and (9.3±0.5)days. One patient was complicated with abdominal infection and diffuse peritonitis (non anastomotic leakage related), and cured by abdominal drainage. No anastomotic leakage, bleeding, peritoneal bleeding occurred, and no patient died during the operation. All patients received R0 resection, and the number of lymph nodes dissected was 45±18 (range, 26 -90), and the number of lymph node with positive expression was 0-72. Ten patients were followed up. They were satisfied to the food intake and the heartburn symptom was controlled.
Conclusion:Roux-en-Y anastomosis combined with pouch digestive tract reconstruction after total gastrectomy is safe, feasible, and the short term efficacy is satisfactory.