Effect of Roux-en-Y reconstruction with jejunal pouch after total gastrectomy : a systematic review        YANG Yu-shang*, YANG Ke-hu, ZHOU Xia-dong, et al. *Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University; the First Clinical Medical College of Lanzhou University, Lanzhou 73000, China
Corresponding author：LIU Ya-li  E-mail: lyl_201006@126.com
Abstract    Objective    To evaluate the curative effectiveness and safety of Roux-en-Y reconstruction with jejunal pouch after total gastrectomy to provide reference for the further clinical study and evidence based clinical practice. Methods    Systematic literature retrieval was carried out to obtain studies of randomized controlled trials comparing Roux-en-Y reconstruction with jejunal pouch and simple Roux-en-Y after total gastrectomy before October 2010. Study selection, data collection and methodological quality assessment of studies were performed by two individual reviewers. A meta-analysis was performed by RevMan 5.0 software. Results    Twelve RCTs involving 577 patients met the selection criteria. Meta-analyses showed that Roux-en-Y reconstruction with jejunal pouch was better than simple Roux-en-Y in terms of 3- and 6-month body weight, 1- and 2- year quality of life and reducing the incidence of dumping at 3, 6 and 12~15 months after surgery. The postoperative complication incidence, postoperative morbidity and operation time were similar between the two groups. Conclusion    The efficacy of Roux-en-Y reconstruction with jejunal pouch on the digestive tract reconstruction is better than that of Roux-en-Y alone in the early time. However, further studies are needed to confine the long-term effect of the former.