[Total gastrectomy with preserving duodenal passage by double tract reconstruction in patients with gastric cancer].

Abstract

Objective: To evaluate the immediate and long-term functional results of total gastrectomy (TGE) with restoration of duodenal passage through double tract reconstruction (DTR) in comparison with Roux-en-Y reconstruction.

Material and methods: The study included 55 patients with gastric cancer who underwent TGE. They were divided into 2 groups: I - TGE with DTR (n=29); II - TGE with Roux-en-Y reconstruction (n=26). Follow-up examination was performed in 3, 6 and 12 months after surgery. Short-term results, nutritional status, morbidity and severity of dumping syndrome, as well as GSRS scores of the quality of life were assessed.

Results: TGE with DTR does not increase duration of surgery, blood loss and postoperative morbidity. Patients after TGE and DTR were characterized by faster and more complete recovery of body weight, BMI, serum transferrin and NRI within 6 and 12 months after surgery. No between-group differences in the incidence and severity of reflux esophagitis were found. Availability of duodenum for endoscopic examination was 93.1%. TGE with DTR was followed by significantly lower incidence and severity of dumping syndrome. Patients with DTR reconstruction were characterized by faster recovery of the quality of life.

Conclusion: TGE with DTR in patients with gastric cancer is characterized by comparable short-term results, faster recovery of nutritional status and quality of life in long-term period after surgery, lower incidence and severity of dumping syndrome.