ORIGINAL RESEARCH article
Front. Surg.
Sec. Surgical Oncology
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1556183
This article is part of the Research TopicProgress of New Technologies in Gastric Cancer Minimally Invasive TreatmentsView all 3 articles
Novel Reconstruction Procedure After Total Gastrectomy: Clinical Application of Adjustable Double-Channel Digestive Tract Reconstruction of Jejunal Interposition
Provisionally accepted
- 1Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- 2Department of Gastrointestinal Surgery, Sichuan Mianyang 404 Hospital, Mianyang, China
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Although diverse reconstruction techniques exist after total gastrectomy for gastric cancer, they have limited effectiveness. Adjustable double-channel digestive tract reconstruction of jejunal interposition (a-DJI) is an improved approach. This study compares this procedure with Roux-en-Y (RY) anastomosis to assess its clinical efficacy post-gastrectomy.The patients in this randomized controlled trial assigned patients to either the a-DJI group (experimental) or the RY group (control). Patients were followed for a total period of 1 year. Primary endpoints included perioperative indices; time to first flatus or feeding; complications (reflux esophagitis, dumping syndrome, and Roux retention syndrome); nutritional status (hemoglobin, total protein, albumin, vitamin D, and calcium); and dietary status.From January 2021 to February 2023, 77 patients were enrolled with 39 and 38 patients in the a-DJI and RY groups, respectively. Reconstruction time, intraoperative blood loss, or time to first flatus/feeding did not differ significantly between groups (all P > 0.05). The a-DJI group had significantly lower rates of reflux esophagitis, dumping syndrome, and Roux retention syndrome (all P < 0.05) than those in the RY group. The a-DJI group was more likely to consume <300 mL per meal and >5 meals per day than the RY group (all P < 0.05). Body weight, hemoglobin, total protein, and albumin levels decreased lesser in the a-DJI group than those in the RY group (all P < 0.05). Vitamin D and calcium levels were higher in the a-DJI group than those in the RY group (all P < 0.05).The a-DJI is superior to RY in reducing complications and improving nutritional status in patients with gastric cancer after total gastrectomy.
Keywords: Stomach Neoplasms, Total gastrectomy, reconstruction, Roux-en-Y anastomosis, Nutritional Status
Received: 06 Jan 2025; Accepted: 23 Apr 2025.
Copyright: © 2025 Zhou, Yang, Chen, Tao, Zhou, Ming and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huai Wu Jiang, Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
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