Interim report of prospective clinical study of two different digestive tract reconstruction after total gastrectomy

Objective To compare post-operative long-term complications and quality of life of two digestive reconstruction procedures after total gastrectomy. Methods A total of 109 gastric cancer patients in Tianjin Medical University Cancer Hospital from March 2012 to February 2013 were prospectively enrolled and randomly divided into functional jejunal interposition (FJI) group (52 cases) and Roux-en-Y (R-Y) group (57 cases). The post-operative complications, nutritional status, and the quality of life were compared between two groups. Results One, 3 and 6 months after operation, the incidence of R-S syndrome in FJI group was lower as compared to R-Y group[13% (6/45) vs. 37% (18/49) , 3% (1/30) vs. 42% (14/33) , 5% (1/21) vs. 48% (11/23) , all P<0.01], while 3 months after operation, the incidence of reflux and heartburn in FJI group was higher [53% (16/30) vs. 21% (7/33) , P<0.01; 37% (11/30) vs. 12% (4/33) , P<0.05]. There were no significant differences in quality of life questionnaire QLQ-C30 between R-Y and FJI groups. QLQ-STO22 stomach module revealed in FJI group, the eating score was better, but reflux score was worse as compared to R-Y group 3 months after operation (all P<0.01). Conclusions Functional jejunal interposition keeps intestinal continuity preserving and food duodenal passing, which is a reasonable digestive reconstruction procedure. Key words: Stomach neoplasm; Total gastrectomy; Digestive tract reconstruction; Functional jejunal interposition; Quality of life