Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지

Jejunal Interposition after Total Gastrectomy

위전절제시 단순공장간치술의 임상적 의의

  • Bae Jin-Sun (Departments of General Surgery, School of Medicine, Chungnam National University) ;
  • Noh Seung-Moo (Departments of General Surgery, School of Medicine, Chungnam National University, Cancer Research Institute) ;
  • Jeong Hyun-Yong (Departments of Internal Medicine, School of Medicine, Chungnam National University) ;
  • Lee Byong-Seok (Departments of Internal Medicine, School of Medicine, Chungnam National University) ;
  • Cho June-Sik (Departments of Diagnostic Radiology, School of Medicine, Chungnam National University) ;
  • Shin Kyung-Sook (Departments of Diagnostic Radiology, School of Medicine, Chungnam National University) ;
  • Song Kyu-Sang (Departments of Pathology, School of Medicine, Chungnam National University Hospital) ;
  • Lee Tae-yong (Departments of Preventive & Public Health, School of Medicine, Chungnam National University Hospital)
  • 배진선 (충남대학교 의과대학 일반외과) ;
  • 노승무 (충남대학교 의과대학 일반외과, 충남대학교 암공동연구소) ;
  • 정현용 (충남대학교 의과대학 내과) ;
  • 이병석 (충남대학교 의과대학 내과) ;
  • 조준식 (충남대학교 의과대학 진단방사선과) ;
  • 신경숙 (충남대학교 의과대학 진단방사선과) ;
  • 송규상 (충남대학교 의과대학 병리과) ;
  • 이태용 (충남대학교 의과대학 예방의학교실)
  • Published : 2001.12.01
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Abstract

Purpose: The aim of this study was to evaluate the shortterm outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to $86.0\%$ and $87.6\%$ of the recent original body weight in the jejunal interposition (JI) group and to $90.8\%,\;87.0\%$, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the JI group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the JI group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the JI group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the JI group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in $7.1\%$ of the patients in the JI group and in $3.5\%$ in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy.

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