Evaluation of J-pouch reconstruction after total gastrectomy:: ρ-double tract vs. J-pouch double tract

Objective: Various enteric reservoirs have been advocated to improve the quality of life after total gastrectomy. We evaluated the advantages of pouch reconstruction compared with traditional p-double tract reconstruction. Design: Prospective randomized study. Setting: Second Department of Surgery, Hyogo College of Medicine, Japan. Subjects: Forty patients who underwent total gastrectomy for cancer of the stomach were studied. Intervention: Forty patients were randomly divided into two groups: 20 patients received rho -double tract reconstruction (RDT group), and 20 underwent J-pouch double tract reconstruction (PDT group) group. Main Outcome Measures: We compared the body weight, serum nutritional parameters, reflux score, scintigraphic esophageal reflux, food intake, and emptying time of the J-pouch or rho -limb between the two groups. Results: No difference was noted between the two groups with regard to body weight, but food intake tended to be higher in the PDT group than in the RDT group. Total protein and albumin levels were higher in the PDT group than in the RDT group, while scintigraphic reflux was significantly less prominent in the PDT group. Conclusions: J-pouch reconstruction was superior with respect to protein metabolism, food intake and reduction of reflux esophagitis compared with the traditional RDT method. However, use of pouch reconstruction did not improve postoperative weight gain. Copyright (C) 2000 S. Karger AG. Basel.