A randomized controlled trial to establish a standard method for reconstruction after total gastrectomy

全胃切除术由于进食困难，对患者的一般状况和生活质量有很大影响。最近，有报道称流产袋重建术(AP重建术)可以使用额外的线性吻合器轻松地完成空肠袋的重建术。为评价该方法的有效性和安全性，将100例全胃切除R0根治术患者随机分为AP重建组和Roux-Y组，比较不同术式的疗效和安全性。两组在手术时间、出血量、术后并发症、术后住院时间等方面无明显差异，表明AP重建术是安全的。AP重建在EORTC QLQ-C30问卷中的几个项目和瘦体重方面均优于对照组，但术后1年这些差异均未达到统计学意义。进一步的随访被认为是必要的，另一次是在术后3年的调查。

Total gastrectomy substantially affects ongeneral status and quality of life through difficulty in food consumption. Recently, aboral pouch reconstruction (AP reconstruction) was reported in which reconstruction with a jejunal pouch can be performed easily using one extra set of linear staplers. In order to evaluate the efficacy and safety of this method, 100 patients who underwent R0 resection by total gastrectomy were randomized into either AP reconstruction or Roux-Y, and comparisons were made with various endpoints. No differences were found in operating time, amount of blood loss, morbidity and length of postoperative hospital stay, indicating that the AP reconstruction is safe. AP reconstruction was superior in terms of several items included in the EORTC QLQ-C30 questionnaire and lean body mass, but these differences did not reach statistical significance at one year after surgery. Further followup was deemed necessary, another survey at 3 years postoperatively.