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

全胃切除术通过进食困难严重影响总体状态和生活质量。最近，有报道称，在空肠袋重建（AP重建）中，使用一组额外的线性吻合器可以轻松地进行空肠袋重建。为了评价该方法的有效性和安全性，将100例全胃切除术R0切除术患者随机分为AP重建组和Roux-Y组，并进行不同终点的比较。手术时间、出血量、发病率、术后住院时间均无差异，说明AP重建是安全的。AP重建在EORTC QLQ-C30问卷数项及瘦体质量方面优于对照组，但术后1年差异无统计学意义。术后3年再次随访。

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.