Document Detail


Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a randomized trial.
MedLine Citation:
PMID:  18438112     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Roux-en-Y reconstruction with and without jejunal pouch was compared in a randomized controlled trial to identify the optimal reconstruction procedure in terms of quality of life. BACKGROUND DATA: Randomized trials comparing techniques of reconstruction after total gastrectomy have shown controversial results. METHODS: One hundred and thirty-eight patients with gastric cancer were intraoperatively randomized for Roux-en-Y reconstruction with pouch (n = 71) or without pouch (n = 67) after gastrectomy and stratified into curative or palliative resection. Intra- and postoperative complications were recorded. Body weight and quality of life were determined every 6 months with a follow-up of up to 12 years. RESULTS: Both groups were comparable for age, sex, incidence of concomitant disease, and staging. There were no differences in operative time, postoperative complications, and mortality. Short- and long-term weight loss was similar in both groups. In the first postoperative year, there were no benefits of pouch reconstruction in terms of quality of life, independent of the resection status. In the third, fourth, and fifth year after surgery quality of life was significantly improved for patients with a pouch. CONCLUSIONS: Roux-en-Y pouch reconstruction after gastrectomy is simple to perform and safe. Long-term survivors benefit from pouch reconstruction. Therefore, a pouch is recommended for patients with a good prognosis.
Authors:
Martin Fein; Karl-Hermann Fuchs; Andreas Thalheimer; Stephan M Freys; Johannes Heimbucher; Arnulf Thiede
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of surgery     Volume:  247     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-06-03     Revised Date:  2008-11-06    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  759-65     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Wuerzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anastomosis, Roux-en-Y / methods*
Colonic Pouches*
Female
Follow-Up Studies
Gastrectomy*
Humans
Jejunum / surgery*
Male
Middle Aged
Quality of Life
Stomach Neoplasms / pathology,  surgery*
Time Factors
Treatment Outcome
Weight Loss
Comments/Corrections
Comment In:
Ann Surg. 2008 Oct;248(4):689; author reply 689-90   [PMID:  18936586 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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