A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition?

BACKGROUND/AIMS

To determine the optimum pouch reconstruction after total gastrectomy, we conducted a randomized trial to compare the usefulness between PR and PI in terms of quality of life.

METHODOLOGY

Thirty patients younger than 70 years of age were selected and randomly classified into the following 2 groups: pouch and Roux-en-Y (PR; n = 15) and pouch and interposition (PI; n = 15). In each subject, the postoperative symptoms, food intake in a single meal, body weight, serum nutritional parameters, endoscopy, emptying time of the gastric substitute, and gallstone formation were evaluated.

RESULTS

There were no significant differences in terms of the postprandial symptoms, food intake, body weight, and serum nutritional parameters until 2 years postoperative. Endoscopy showed a tendency of food stasis in the PR group, although this was not significant. The gastric emptying test in the PR group indicated that the retention capacity was slightly superior to that in the PI group.

CONCLUSIONS

The impact of the duodenal passage on symptoms and nutrition could not be ascertained.