{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:37Z","timestamp":1753893277788,"version":"3.41.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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 <jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). The a-DJI group had significantly lower rates of reflux esophagitis, dumping syndrome, and Roux retention syndrome (all <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05) than those in the RY group. The RY group was more likely to consume &amp;lt;300\u2005ml per meal and &amp;gt;5 meals per day than the a-DJI group (all <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). Body weight, hemoglobin, total protein, and albumin levels decreased lesser in the a-DJI group than those in the RY group (all <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). Vitamin D and calcium levels were higher in the a-DJI group than those in the RY group (all <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The a-DJI is superior to RY in reducing complications and improving nutritional status in patients with gastric cancer after total gastrectomy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1556183","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T05:38:02Z","timestamp":1746769082000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel reconstruction procedure after total gastrectomy: clinical application of adjustable double-channel digestive tract reconstruction of jejunal 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