{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:54:56Z","timestamp":1773269696266,"version":"3.50.1"},"reference-count":0,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2001,10,22]],"date-time":"2001-10-22T00:00:00Z","timestamp":1003708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2001,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Nearly total gastrectomy preserving the vagal nerve, the lower esophageal sphincter (LES), and the pyloric sphincter was developed as a function\u2010preserving surgical technique to improve postgastrectomy disorders. In this paper, application criteria and technique are outlined, and postoperative quality of life was clinically investigated. Ten subjects who underwent this surgical operation (group A: 7\u00a0male and 3 female subjects at age 48 to 68 years with a mean age of 58.3 years) were interviewed to inquire about reflux esophagitis, dumping syndrome, and microgastria. Group A was compared with 20 cases of conventional total gastrectomy with D2\nlymphadenectomy, excision of the lower esophageal sphincter (LES),\ntotal vagotomy, and single jejunal interposition (group B: 16\u00a0male and\n4 female subjects at age 48 to 72 years with a mean age of 63.9 years).\nIncluded were cases with early cancer (M or SM1 of N0) localizing at the middle third and lower stomach, which was not applicable to endoscopic excision of gastric mucosa or partial gastric excision in M cancer, 2\u00a0cm or farther from the margin of the cancer to the esophagogastric mucosa cephalad junction and 3.5\u00a0cm or farther from the margin of the cancer to the pyloric caudad sphincter; in SM1 cancer, 4\ncm or farther from the oral\u2010side margin of the cancer to esophagogastric mucosa junction and 5.5\u00a0cm or farther from the anal\u2010side margin of the cancer to the pyloric sphincter. In excision with lymph nodes, hepatic and celiac branches bifurcating from anterior and posterior trunks of the vagal nerve were preserved. To preserve LES, the esophagus was severed at the His angle at right angle to the longitudinal axis of the esophagus. The antrum was severed at 1.5\u00a0cm from the pyloric sphincter, preserving the arteria supraduodenalis. An alternative gaster was created as a 15\u2010cm jejunal pouch with a 5\u2010cm jejunal conduit for orthodromic peristaltic movement, using an automatic suture instrument to complete side\u2010to\u2010side anastomosis of folded jejunum with 1\u2010 to 1.5\u2010cm long upper end of the pouch not anastomosed. The abdominal esophagus was mechanically anastomosed with a jejunal J pouch, and anastomosis of the pyloric antrum with a jejunal conduit was manually completed by stratum anastomosis. In group A, food ingestion per time could be taken the same as that of a healthy person,\nwith no reflux esophagitis and dumping syndrome being noticed. Reflux esophagitis developed more significantly in group B than in group A\n(p &lt; 0.05). In food ingestion per time, group B was significantly delayed compared with group A (p &lt;\n0.05). The present results suggested that the surgical technique proposed is a function\u2010preserving gastric surgery appropriate to prevent postgastrectomy disorder of subjects.\n<\/jats:p>","DOI":"10.1007\/s00268-001-0163-8","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T17:38:52Z","timestamp":1398188332000},"page":"1524-1531","source":"Crossref","is-referenced-by-count":16,"title":["Operative Technique on Nearly Total Gastrectomy Reconstructed by Interposition of a Jejunal J pouch with Preservation of Vagal Nerve, Lower Esophageal Sphincter, and Pyloric Sphincter for Early Gastric Cancer"],"prefix":"10.1002","volume":"25","author":[{"given":"Ryouichi","family":"Tomita","sequence":"first","affiliation":[{"name":"Department of Surgery Nippon Dental University 2\u20103\u20106 Fujimi, Chiyoda\u2010ku Tokyo 102\u20108158 Japan<!--<country1>Japan<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Fujisaki","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Medicine 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku Tokyo 173\u20100032 Japan<!--<country1>Japan<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhisa","family":"Tanjoh","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Medicine 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku Tokyo 173\u20100032 Japan<!--<country1>Japan<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Medicine 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku Tokyo 173\u20100032 Japan<!--<country1>Japan<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,10,22]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-001-0163-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-001-0163-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-001-0163-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T19:51:51Z","timestamp":1703706711000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-001-0163-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,10,22]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2001,12]]}},"alternative-id":["10.1007\/s00268-001-0163-8"],"URL":"https:\/\/doi.org\/10.1007\/s00268-001-0163-8","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,10,22]]}}}