- 作者：Srdjan Dikic ; M.D. ; Ph.D.&lowast ; ; &dagger ; ; srdjan_dikic@yahoo.com ; Tomislav Randjelovic ; M.D. ; Ph.D.&lowast ; ; &dagger ; ; Svetlana Dragojevic ; M.D. ; Ph.D.&dagger ; ; &Dagger ; ; Dragoljub Bilanovic ; M.D. ; Ph.D.&lowast ; ; &dagger ; ; Miroslav Granic ; M.D. ; Ph.D.&dagger ; ; § ; ; Dragan Gacic ; M.D. ; M.A.&lowast ; ; Darko Zdravkovic ; M.D. ; Ph.D.&dagger ; ; § ; ; Branislav Stefanovic ; M.D. ; Ph.D.&dagger ; ; 鈥?/sup> ; Aleksandra Djokovic ; M.D. ; M.A.&dagger ; ; ¶ ; ; Vladimir Pazin ; M.D. ; Ph.D.&dagger ; ; &Dagger ;
- 关键词：gastric carcinoma ; preduodenal pouch ; transit time ; (PDP) preduodenal pouch
- 刊名：Journal of Surgical Research
- 出版年：2012
- 期刊代码：299_00224804
- 类别：med
- 出版时间：1 June, 2012
- 卷：175
- 期：1
- 页码：56-61
- 文件大小：377 K
Background
Total gastrectomy causes numerous disorders, such as reflux esophagitis, dumping syndrome, malabsorption, and malnutrition. To minimize the consequences, different variants of reconstruction are performed. The aim of our study is the comparison of two reconstructive methods: the standard Roux-en-Y and a new modality of pouch interposition, preduodenal-pouch interposition. This study aims to investigate the advantage of bile reflux prevention and to reduce symptoms of dumping syndrome after 3- and 6-mo follow-up.Materials and Methods
A total of 60 patients were divided in two groups: (A) 30 patients with Roux-en-Y reconstruction, and (B) 30 patients with the preduodenal-pouch (PDP) type of reconstruction. Endoscopic examination and endoluminal jejunal limb pressure measurements were performed. Scintigraphic measurements of half-emptying time were performed to evaluate meal elimination in the context of reflux esophagitis and early dumping syndrome. The Japan Society of Gastrointestinal Surgery has provided guidelines with which to classify the symptoms of early dumping syndrome. Patients were followed up for periods of 3 and 6 mo after the surgery.
Results
Our study groups did not differ with regard to the level of reflux esophagitis (P = 0.688). Average values of pressure at 10 and 15 cm below the esophago-jejunal junction were significantly lower in聽the PDP group (P < 0.001). Elimination of the test聽meal between two groups was not significant (P聽= 0.222). Evaluation of early dumping syndrome symptoms revealed a significant reduction among PDP patients聽after 3 and 6 mo.
Conclusion
Our study showed significant superiority of the new pouch reconstruction over the standard Roux-en-Y approach in the treatment of early dumping syndrome.