Simple versus double jejunal pouch for reconstruction after total gastrectomy

Florio, Maria Antonietta Gioffrè; Bartolotta, M; Miceli, Joseph C; Giacobbe, G; Saitta, Francesco; Paparo, M.Teresa; Micali, B

doi:10.1016/s0002-9610(00)00419-0

Cited by 28 publications

(22 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, individual studies of pouch design are generally limited by small patient numbers, short follow-up, and variable outcome measures [10,[15][16][17]. Due to this variability, a metaanalysis of studies cannot be conducted and, hence, a defi nitive statement of the benefi t of pouch reconstruction cannot be made.…”

mentioning

confidence: 99%

Optimal gastric pouch reconstruction post-gastrectomy

et al. 2008

View full text Add to dashboard Cite

mentioning

confidence: 99%

Optimal gastric pouch reconstruction post-gastrectomy

et al. 2008

View full text Add to dashboard Cite

“…In another trial, when they compared an oral pouch with duodenal passage preservation and an oral pouch without duodenal passage preservation, no differences were found, even in serum protein levels [26]. In Gioffre Florio's study [19], as mentioned above, a double pouch (oral + aboral) resulted in higher protein and albumin levels than an oral pouch only.…”

Section: Discussionmentioning

confidence: 99%

“…Randomized studies published in this fi eld mainly question the importance of reservoir construction [1,[9][10][11][12][13][14][15][16][17][18][19][20][21][22]; fewer trials research the importance of duodenal passage preservation [11,14,[23][24][25][26]. Two expert reviews have been published, each trying to draw evidence-based conclusions by means of a metaanalysis of all available randomized trials [27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have created both types of pouches in one reconstruction. In the study of Gioffre'Florio et al [19], the oral pouch was compared with a double-pouch method combining oral pouch construction with an inframesocolic aboral pouch construction, similar to our aboral pouch, except that in our method, the anastomosis is performed in an anisoperistaltic fashion, while in the lower pouch of Gioffre'Florio's [19] double-pouch method, the anastomosis is performed in an isoperistaltic fashion. They found better weight gain and quality of life and higher serum albumin and total protein in patients with the double pouch compared to fi ndings in patients with the J-pouch, which also supports the superiority of the J-pouch.…”

Section: Discussionmentioning

confidence: 99%

“…Thus these higher albumin levels do not refl ect a better protein metabolism in the OP patients in general. Serum protein and albumin-as some of the most well-known nutritional laboratory measures-have been examined in some studies [11,19,21], but were found to be affected in only few [11,19]. Nakane et al [11] found a significantly higher protein level in patients with an oral pouch with duodenal exclusion reconstruction, compared to Roux-en-Y, 12 and 24 but not 6 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Comparing aboral versus oral pouch with preserved duodenal passage after total gastrectomy: does the position of the gastric substitute reservoir count?

et al. 2008

View full text Add to dashboard Cite

ing the duodenum, and respond properly to the changing levels of gastrointestinal hormones and neural information. The science of surgery is nowhere near reaching this ideal. With the gold standard Roux-en-Y reconstruction so far achieved, gastrectomized patients do not suffer from alkaline esophagitis. Different pouch construction methods and reconstructions of the duodenal passage are being trialled to improve functional results.In our previous studies, a Roux-en-Y-based but distally reconstructed pouch-the aboral pouch-was compared to Roux-en-Y reconstruction, as well as being compared to reconstruction with an aboral pouch and duodenal passage preservation [1][2][3][4]. Absorption studies supported pouch construction; gastrointestinal hormone studies suggested the superiority of duodenal passage preservation [4]. In this study, the site of the pouch is examined; two different reconstruction types, the traditional oral pouch and the aboral pouch, are compared. Based on our gastrointestinal hormonal studies, we believe in the superiority of duodenal passage preservation, that is why both pouch reconstructions were performed with duodenal passage preservation. Patients and methods Eligibility criteria and randomizationAll patients with a disease necessitating total gastrectomy were investigated for eligibility to enter the trial. Patients younger than 80 years, who had no historical data of previous bowel resection and in whom kidney and liver function tests had shown normal results, and in whom R0 resection could be performed, were considered eligible. During the operation, after evaluation of the feasibility of both reconstruction methods and clearance for technical resectability, randomization was performed via the envelope selection method. AbstractBackground. Total gastrectomy results in a signifi cant weight loss, different postgastrectomy symptoms, and a reduction in quality of life. Elaborate surgical reconstruction methods are evaluated to improve results. The present study compares two types of reconstructions-an aboral pouch with preserved duodenal passage and an oral pouch with preserved duodenal passage-differing only in the site of the pouch. Methods. Twenty-eight patients entered the study. Primary outcome measures-body weight, body mass index, and quality of life, and secondary outcome measures-serum nutritional parameters, scintigraphic small-intestinal passage, and lipid and carbohydrate absorption were measured 6, 12, and 24 months after surgery. Results. No signifi cant differences were found in anthropometric parameters or in quality of life between the groups. Regarding the secondary outcome measures, albumin levels were higher in the oral pouch group, while protein and immunoglobulin-A levels were higher in the aboral pouch group. Conclusion. The site of the reservoir does not signifi cantly infl uence the outcome after total gastrectomy and reconstruction with a preserved duodenal passage.

show abstract

Effects of creating a jejunal pouch on postoperative quality of life after total gastrectomy: A cross‐sectional study

Tsuji

Isobe

Seto

et al. 2021

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Aim Total gastrectomy results in the complete loss of gastric function and the development of severe postgastrectomy syndrome. During the jejunal pouch procedure following total gastrectomies, a substitute stomach is created to alleviate the effects of postgastrectomy syndrome. However, the procedure's effectiveness remains controversial. This study aimed to explore the effect of jejunal pouch creation after total gastrectomy on postoperative quality of life. Methods A nationwide multi‐institutional cross‐sectional study, the Postgastrectomy Syndrome Assessment study NEXT, used the Postgastrectomy Syndrome Assessment Scale‐45 questionnaire to explore the optimal gastrectomy procedure for cancer located in the upper third of the stomach or around the esophagogastric junction. The questionnaire consists of 45 items consolidated into 19 main outcome measures relating to postgastrectomy symptoms, amount of food ingested, quality of ingestion, ability for working, level of satisfaction for daily life, and the physical and mental component summary of the 8‐Item Short Form Health Survey. Eligible completed questionnaires were retrieved from 1909 patients. Of these, the data were analyzed for 1020 patients who underwent total gastrectomy and 93 patients who underwent jejunal pouch creation after total gastrectomy. Results Postoperative quality of life was compared between patients with and without pouches. The analysis revealed that patients with pouches, particularly oral pouches, experienced substantially improved postoperative quality of life than those without, even after adjusting for several clinical factors using multiple regression analyses. Conclusion The results suggest that total gastrectomy with jejunal pouch creation, particularly oral pouches, may significantly improve postoperative quality of life.

show abstract

Simple versus double jejunal pouch for reconstruction after total gastrectomy

Cited by 28 publications

References 11 publications

Optimal gastric pouch reconstruction post-gastrectomy

Optimal gastric pouch reconstruction post-gastrectomy

Comparing aboral versus oral pouch with preserved duodenal passage after total gastrectomy: does the position of the gastric substitute reservoir count?

Effects of creating a jejunal pouch on postoperative quality of life after total gastrectomy: A cross‐sectional study

Contact Info

Product

Resources

About