Clinical Research Of Gastrointestinal Reconstruction By Continuous Jejuna Interposition After Total Gastrectomy

Objective: This article intends to discuss the clinical value of gastrointestinal reconstruction by continuous jejuna interposition after total gastrectomy.Methods: Between January 2005 and December 2014 in The People’s Hospital of Xingtai City, 48 cases of continuous jejuna interposition after total gastectomy(Group A) were collected from the participants to compare the complication 、 visick rating index and nutritive index with conventional Roux-en-Y gastrointestinal reconstruction(Group B) and Roux-en-Y + jejuna interposition(Group C).Results:1 Comparison of complications between continuous jejuna interposition and conventional gastrointestinal reconstructionsIn three groups of gastrointestinal reconstruction after total gastrectomy, the frequency of postoperative dumping syndrome(low-to-high)were: Group A 6.2%(3 cases), Group B 20%(6 cases), Group C 25%(9 cases); the frequency of reflux esophagitis(low-to-high) were: Group A 4.1%(2 cases), Group C 16.7%(6 cases), Group B 33.3%(10 cases); the frequency of RS syndrome(low-to-high) were: Group A 4.1%(2 cases), Group B 20%(6 cases), Group C 33.3%(12 cases); the frequency of diarrhea(low-to-high) were: Group A 0 %(0 cases), Group B 20%(6 cases), Group B 25%(9 cases).The results showed: After total gastrectomy, there were lower frequency of complications in continuous jejuna interposition group.2 Comparison of Visick rating index between continuous jejuna interposition and conventional gastrointestinal reconstructionsIn three groups of gastrointestinal reconstruction after total gastrectomy, the frequency of Visick I(high-to-low)were: Group A 60.4%(29 cases), Group C 25%(9 cases), Group B 20%(6 cases); the frequency of Visick II(high-to- low)were: Group B 40%(12 cases), Group C 38.9%(14 cases), Group A 29.2%(14 cases); the frequency of Visick III(high-to- low)were: Group C 30.6%(11 cases), Group B 30%(9 cases), Group A 10.4%(5 cases); the frequency of Visick IV(high-to- low)were: Group B 10 %(3 cases), Group C 5.5%(2 cases), Group A 0%(0 cases).The results showed: After total gastrectomy, there were better Visick rating index in continuous jejuna interposition group.4 Comparison of nutritive index between continuous jejuna interposition and conventional gastrointestinal reconstructionsIn three groups of gastrointestinal reconstruction after total gastrectomy, the frequency of dietary allowance>300ml/meal(high-to-low)were: Group A 87.5%(42 cases), Group C 86.1%(31 cases), Group B 60%(18 cases); the growth figure(high-to- low)were: 5.2kg, Group C 3.12 kg, Group B 3.01kg; the HB generation index(high-to- low)were: Group A 12.66g/L, Group C 10.89 g/L, Group B 8.72 g/L; the albuminar generation index(high-to- low)were: Group A 7.52g/L, Group C 5.62g/L, Group B 3.23 g/L.The results showed: After total gastrectomy, there were better nutritive index in continuous jejuna interposition group.Conclusions:1 After total gastrectomy, there were lower frequency of complications in continuous jejuna interposition group.2 After total gastrectomy, there were better Visick rating index in continuous jejuna interposition group.3 After total gastrectomy, there were better nutritive index in continuous jejuna interposition group.