- 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.&lowast ; ; &Dagger ; ; Dragan Gacic ; M.D. ; M.A.&dagger ; ; Dragoljub Bilanovic ; M.D. ; Ph.D.&lowast ; ; &dagger ; ; Vesna Vulovic ; M.D.&dagger ; ; Igor Jovanovic ; M.D.&dagger ; ; Spaso Andjelic ; M.D. ; M.A.&Dagger ;
- 关键词：gastric carcinoma ; preduodenal pouch ; QoL ; preduodenal jejunal pouch (PDP)
- 刊名：Journal of Surgical Research
- 出版年：2012
- 期刊代码：299_00224804
- 类别：med
- 出版时间：July, 2012
- 卷：176
- 期：1
- 页码：34-41
- 文件大小：252 K
Background
Various types of reconstructions have been developed to improve the quality of life of patients following total gastrectomy. In addition, to ensure larger food-intake reservoirs and extend meal transit times, different types of pouch reconstructions have been developed and described. Our opinion is that the most important factor in providing better physiologic regulation of ingested food is restoration of the duodenal passage and enlargement of the gastric substituent.Materials and Methods
In the present study, we compared standard a Roux-en-Y reconstruction and a preduodenal pouch (PDP) reconstruction. We evaluated the quality of life (QoL) for 60 patients during the first postoperative year, comparing serum albumin, protein, hemoglobin, iron, body weight, body mass index, and QoL. QoL was defined according to Korenaga鈥檚 score scale, which has 14 questions, for better understanding of subjective patient perceptions of digestive function.
Results
Our study population did not differ in iron and hemoglobin levels at a 1-y follow-up. The difference between total serum albumin level was significant in all observed patients in the follow-up period in favor of the PDP reconstruction group (P = 0.001). The PDP reconstruction group also had a significantly higher serum protein level after 12 mo. The higher score difference between the two groups generally confirm the improved QoL in the PDP group (P = 0.001).
Conclusion
The most important aspects of improved QoL after gastrectomy due to gastric carcinoma are maintenance of the duodenal transit and the addition of a pouch. Jejunal preduodenal pouches provide a better QoL than Roux-en-Y reconstruction. Our study results suggest preduodenal pouch reconstruction should be used as the method of choice.