Original Articles
Copyright ©The Author(s) 1999. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 15, 1999; 5(1): 34-37
Published online Feb 15, 1999. doi: 10.3748/wjg.v5.i1.34
Consequence alimentary reconstruction in nutritional status after total gastrectomy for gastric cancer
Yin-Ai Wu, Bin Lu, Jun Liu, Jiang Li, Jiang-Rong Chen, Shi-Xiong Hu
Yin-Ai Wu, Bin Lu, Jun Liu, Jiang Li, Shi-Xiong Hu, Department of General Surgery, the 157th Center Hospital of PLA, Guangzhou 510510, Guangdong Province, China
Jiang-Rong Chen, The Second Affiliated Hospital of First Military Medical University, Guangzhou 510524, Guangdong Province, China
Yin-Ai Wu, male, born on 1962-12-09 in Shanrao City, Jiangxi Province, graduated from First Military Medical University in 1989, now working as a chief doctor and director of surgery, having 26 pa-pers published as the first author, and editor in chief for “Anal Re-construction” and “Surgical Treatme nt of Proctological Cancer”
Author contributions: All authors contributed equally to the work.
Supported by the Science and Education Development Foundation for Medicine of Guangdong Provincial Health Department, No.9626.
Correspondence to: Dr. Yin-Ai Wu, Department of General Surgery, the 157th Center Hospital of PLA, Guangzhou 510510, China
Telephone: +86-20-87783158 Fax: +86-20-87706157
Received: October 4, 1998
Revised: November 12, 1998
Accepted: November 24, 1998
Published online: February 15, 1999

AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrecto-my.

METHODS From 1989-1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun’s esopha-go-jejunostomy (EJ) and 5 with Lawrance’s Roux-en-Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumu-late and use the absorbed nutrients.

RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food in-take in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duode-num or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters c ould fall in the normal range.

CONCLUSION The most common mechanism responsible for postoperative malnutrition was in-adequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.

Keywords: stomach neoplasms, gastrec-tomy, nutritional status, nutrition disorders, esophagitis