Total gastrectomy for XXXX : is reconstruction or a gastric replacement reservoir essential?

@entity1 @entity2681 @entity4 @entity1066 @entity5 @entity2910 @entity450 @entity460 @entity3147 @entity413 @entity68
Malnutrition is a frequently observed complication of total gastrectomy. Does the mode of reconstructing the alimentary tract bear part of the responsibility? We assessed our experience from January 1975 to 1992 to analyze this issue. A series of 64 total gastrectomy @entity1 [40 @entity1 , 24 @entity1 ; aged 59 +/- 11 (SD) years] were considered. Preoperative and periodic follow-up evaluations were prospectively documented: upper gastrointestinal series, endoscopic examination, complete blood count, serum and liver biochemistry profiles, serum proteins, tranferrin, serum @entity68 and @entity460 , @entity68 -binding capacity, oral @entity413 tolerance test, ultrasonography or computed tomography, actual and ideal body weight and performance (AJCC/UICC) assessments. Symptoms were classified by means of Cuschieri's scoring system. Esophageal mucosal changes ( @entity4 , @entity450 , @entity2681 , @entity1066 ) were documented on endoscopy. There were 36 of 58 operative survivors who had no evidence of @entity5 recurrence and were available for long-term evaluation (12-132 months). An RY loop had been constructed in 25 @entity1 , 5 with a Hunt pouch; 9 had an isoperistaltic jejunal interposition (IJI), 4 with a Kock pouch; and 2 had a Braun loop. A 60 to 70 cm long jejunal limb was always utilized. Statistical analyses were obtained by means of the Student t-test and the equality of medians test. Progressive @entity3147 was observed in @entity1 with the Braun (omega) loops, both @entity1 displaying persistent @entity2910 and dietary restrictions. Both recovered ideal body weight after remedial surgery that transformed the omega loop into an RY loop. Both RY and IJI loops effectively prevented alkaline @entity2910 .(ABSTRACT TRUNCATED AT 250 WORDS)
