Advantages of jejunal pouch in Roux-en-Y reconstruction.

Background/aims: To improve the quality of life of patients after total gastrectomy, various pouch-reconstruction techniques have been developed. However, pouch reconstruction is technically challenging and remains controversial. We therefore, determined the efficacy of the addition of a jejunal pouch to Roux-en-Y reconstruction after total gastrectomy.

Methodology: We retrospectively studied 68 gastric cancer patients who had undergone total gastrectomy with simple Rouxen- Y reconstruction (RY group) or with Roux-en-Y reconstruction and jejunal pouch (JP group).

Results: Six months after discharge from the hospital, the mean total serum albumin level was significantly lower in the RY group than in the JP group, but the mean weight loss and incidence of reflux esophagitis did not differ between the 2 groups.

Conclusions: The addition a jejuna pouch to Roux-en-Y reconstruction provides better reservoir function, but does not influence the incidence of reflux esophagitis. The construction of new fundus-like jejunal plication and the smooth passage of food from the esophagus to the jejunum prevent reflux esophagitis after total gastrectomy.