Evaluation of Double Tract Reconstruction After Total Gastrectomy in Patients with Gastric Cancer: Prospective Randomized Controlled Trial
Evaluation of Double Tract Reconstruction After Total Gastrectomy in Patients with Gastric Cancer: Prospective Randomized Controlled Trial
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DOI：
10.1007/s00268-009-0109-0
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发表时间：
2009-09-01
影响因子：
2.6
通讯作者：
Yamaue, Hiroki
中科院分区：
文献类型：
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作者：
Iwahashi, Makoto;Nakamori, Mikihito;Yamaue, Hiroki
比较双通道法（DT法）和Roux-en-Y法（R-Y法）在胃癌全胃切除术后的重建方式。DT重建与R-Y重建一样简单，即使在全胃切除术后也可以安全地进行。一组44例胃癌患者行全胃切除术（TG）后，术中随机分为两组，每组23例，行R-Y重建术（n = 23），行DT重建术（n = 21）。在术后3个月和12个月测定体重、食物摄入量、营养状况和生活质量（QOL）。该研究在ClinicalTrials.gov上注册，编号NCT 00746161。术后不久，摄食量显著减少。DT组和R-Y组之间未观察到差异。在随后的时间内，体重下降（P < 0.05），随后逐渐恢复。然而，两组之间没有观察到差异。在营养实验室参数中，血清前白蛋白、视黄醇结合蛋白、总胆固醇和甘油三酯在手术后不久下降。这些参数的变化在两组之间没有实质性差异。术后生活质量评价结果显示，两组间无显著性差异，TG后DT法与单纯R-Y法相比，在体重、生活质量、营养状况等方面均无明显优势，提示胃癌患者TG后DT法不推荐使用。
The double tract (DT) method was compared with the Roux-en-Y (R-Y) method to identify the optimal reconstruction procedure after total gastrectomy for patients with gastric cancer. The DT reconstruction is as simple as the R-Y, and it can be safely performed even after total gastrectomy. However, these have been no studies evaluating the usefulness of DT reconstruction in comparison to R-Y reconstruction.A group of 44 patients with gastric cancer were intraoperatively randomized for R-Y (n = 23) or DT reconstruction (n = 21) after total gastrectomy (TG). Body weight, food intake, nutritional conditions, and quality of life (QOL) were determined at 3 and 12 months after the operation. This study is registered with ClinicalTrials.gov, no. NCT00746161.Food intake significantly decreased soon after the operation. No differences were observed between the DT and R-Y groups. The body weight decreased throughout the ensuing period (P < 0.05) and thereafter gradually recovered. However, no differences were observed between the two groups. Among the nutritional laboratory parameters, serum prealbumin, retinol-binding protein, total cholesterol, and triglyceride were decreased soon after the operation. The changes of those parameters were not substantially different between the two groups. The postoperative QOL was evaluated, and no differences were observed between those groups.There were no particular advantages in the DT method after TG in comparison to the simple R-Y method in terms of body weight, QOL, and nutritional conditions, suggesting that the DT method might not be recommended after TG for patients with gastric cancer.