Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy
Aim: An innovative method of digestive tract reconstruction following proximal gastrectomy, the uncut interposed jejunum pouch, esophagus and residual stomach double anastomosis(Uncut-D), was established in recent years. In order to fully clarify the superiority of the procedure, this study has cond...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422016281 |
| _version_ | 1797669995150311424 |
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| author | JiaQing Gong Xia Liu GuangLan Wang Wei Li GuoDe Luo Yan Lin Bin Zhang ChuanDong Chen |
| author_facet | JiaQing Gong Xia Liu GuangLan Wang Wei Li GuoDe Luo Yan Lin Bin Zhang ChuanDong Chen |
| author_sort | JiaQing Gong |
| collection | DOAJ |
| description | Aim: An innovative method of digestive tract reconstruction following proximal gastrectomy, the uncut interposed jejunum pouch, esophagus and residual stomach double anastomosis(Uncut-D), was established in recent years. In order to fully clarify the superiority of the procedure, this study has conducted a systematic analysis and thorough discussion. Methods: 118 patients with adenocarcinoma of the esophagogastric junction who underwent proximal gastrectomy were enrolled in this study. According to the methods of digestive tract reconstruction, these patients were divided into three groups: Uncut-D(n = 43), esophagogastrostomy (EG, n = 36), jejunal interposition (JI, n = 39).The preoperative indicators, surgical complications and related indicators of postoperative quality of life were analyzed. Results: There were no significant differences in preoperative data among all groups (P > 0.05); The digestive tract reconstruction time in Uncut-D group was more than that in EG group, and less than that in JI group (P < 0.05). The incidence of esophageal anastomotic stenosis in Uncut-D group was significantly lower than that in EG group (P < 0.05); In Uncut-D group, the incidence of reflux esophagitis, postoperative nutrition index(PNI), weight recovery and Visick classification were significantly better than those in EG group (P < 0.05), furthermore, the incidence of delayed gastric emptying,PNI and weight recovery were better than those in JI group (P < 0.05). Conclusions: The Uncut-D procedure gave full play to jejunal continuity and the advantages of pouch, and played a valuable role in gastric and cardiac replacement, which significantly reduced long-term complications, improved postoperative nutritional status of patients and long-term quality of life. |
| first_indexed | 2024-03-11T20:53:06Z |
| format | Article |
| id | doaj.art-d1b2fa67e01a4287a1186bdfcba5f8bb |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-11T20:53:06Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-d1b2fa67e01a4287a1186bdfcba5f8bb2023-10-01T05:57:33ZengElsevierAsian Journal of Surgery1015-95842023-10-01461041964201Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomyJiaQing Gong0Xia Liu1GuangLan Wang2Wei Li3GuoDe Luo4Yan Lin5Bin Zhang6ChuanDong Chen7Department of General Surgery, Dujiangyan Shoujia Hospital, Chengdu, Sichuan Province, China; Corresponding author. Department of General Surgery, Dujiangyan Shoujia hospital, Chengdu, 611830, Sichuan Province, China.Department of Medical Laboratory, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, ChinaDepartment of Ultrasound,The General Hospital of Western Theater Command, Chengdu, Sichuan Province, ChinaDepartment of General Surgery, Dujiangyan Shoujia Hospital, Chengdu, Sichuan Province, ChinaDepartment of General Surgery, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, ChinaDepartment of General Surgery, Dujiangyan Shoujia Hospital, Chengdu, Sichuan Province, ChinaDepartment of General Surgery, Dujiangyan Shoujia Hospital, Chengdu, Sichuan Province, ChinaDepartment of General Surgery, Dujiangyan Shoujia Hospital, Chengdu, Sichuan Province, ChinaAim: An innovative method of digestive tract reconstruction following proximal gastrectomy, the uncut interposed jejunum pouch, esophagus and residual stomach double anastomosis(Uncut-D), was established in recent years. In order to fully clarify the superiority of the procedure, this study has conducted a systematic analysis and thorough discussion. Methods: 118 patients with adenocarcinoma of the esophagogastric junction who underwent proximal gastrectomy were enrolled in this study. According to the methods of digestive tract reconstruction, these patients were divided into three groups: Uncut-D(n = 43), esophagogastrostomy (EG, n = 36), jejunal interposition (JI, n = 39).The preoperative indicators, surgical complications and related indicators of postoperative quality of life were analyzed. Results: There were no significant differences in preoperative data among all groups (P > 0.05); The digestive tract reconstruction time in Uncut-D group was more than that in EG group, and less than that in JI group (P < 0.05). The incidence of esophageal anastomotic stenosis in Uncut-D group was significantly lower than that in EG group (P < 0.05); In Uncut-D group, the incidence of reflux esophagitis, postoperative nutrition index(PNI), weight recovery and Visick classification were significantly better than those in EG group (P < 0.05), furthermore, the incidence of delayed gastric emptying,PNI and weight recovery were better than those in JI group (P < 0.05). Conclusions: The Uncut-D procedure gave full play to jejunal continuity and the advantages of pouch, and played a valuable role in gastric and cardiac replacement, which significantly reduced long-term complications, improved postoperative nutritional status of patients and long-term quality of life.http://www.sciencedirect.com/science/article/pii/S1015958422016281Proximal gastrectomyDigestive tract reconstructionUncut jejunal interpositionJejunal pouchAdenocarcinoma of the esophagogastric junction |
| spellingShingle | JiaQing Gong Xia Liu GuangLan Wang Wei Li GuoDe Luo Yan Lin Bin Zhang ChuanDong Chen Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy Asian Journal of Surgery Proximal gastrectomy Digestive tract reconstruction Uncut jejunal interposition Jejunal pouch Adenocarcinoma of the esophagogastric junction |
| title | Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy |
| title_full | Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy |
| title_fullStr | Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy |
| title_full_unstemmed | Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy |
| title_short | Uncut interposed jejunum pouch versus esophago-gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach: An innovative method of digestive tract reconstruction following proximal gastrectomy |
| title_sort | uncut interposed jejunum pouch versus esophago gastrostomy and double anastomoses of jejunum to the esophagus and residual stomach an innovative method of digestive tract reconstruction following proximal gastrectomy |
| topic | Proximal gastrectomy Digestive tract reconstruction Uncut jejunal interposition Jejunal pouch Adenocarcinoma of the esophagogastric junction |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422016281 |
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