***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: This is an interim report of a r and omized clinical trial on esophagojeju-nostomy ( EJ ) versus Hunt-Lawrence-Rodino ( HLR ) pouch as reconstruction techniques following total gastrectomy and systematic lymphadenectomy for gastric cancer treatment . The r and omized trial preceded a pilot study comparing the Longmire-Gütgemann interposition and the HLR .  The pilot study included 7 patients , the r and omized trial 38 patients ( 60 planned ) . The main outcome variables in the pilot study were food resorption , caloric intake , and body weight . Survival probability and general well-being ( quality of life ) were measured in the r and omized trial . A score was composed of disease-specific and socio-personal variables with well-being ranging from 0 ( worst ) to 14 ( best ) points . Concerning food resorption in the pilot study , no relevant advantage of the duodenal passage was found . The main postoperative disorder was insufficient food intake . Despite a radical operation , a hospital mortality rate of 16 % , and a complication rate of 37 % , gastric cancer still has a poor prognosis . In the r and omized trial only 15 ( 39 % ) of 38 patients were alive 1 year after operation , but the survival probability was higher ( 58 % ) after HLR than after EJ ( 24 % ) ( p<0.05 ) . Hunger and appetite were strongly reduced during the first 6 months after operation . Food intake was less than half of the preoperative values , which was reflected by an average decrease in body weight of 7 kg . Patients dying within the first year after total gastrectomy suffered an irreversible loss of quality of life ( scoring 7 points ) . They had no objective benefit from the operation . Patients surviving this period regained quality of life and exceeded preoperative values , especially after HLR.We conclude that HLR-operated patients who have a chance of surviving for at least 1 year benefit from total gastrectomy in regard to quality of life . RésuméCet article est consacré au bilan provisoire d'une étude clinique r and omisée de l'oesophago-jéjunostomie ( EJ ) par rapport à l'opération de Hunt-Lawrence-Rodino ( HLR ) comme technique de reconstruction après gastrectomie totale et lymphadénectomie systématique pour cancer de l'estomac . Le bilan a été établi à partir d'une étude pilote comparant l'interposition Longmire-Gütgemann et la HLR . Cette première étude a porté sur 7 patients et le étude r and omisée sur 38 patients ( 60 sont prévues ) . Dans l'étude pilote la réabsorption intestinale , le poids et l'absorption calorique furent les variables essentielles pour mesurer l'avenir des malades . Dans le étude r and omisée la probabilité de survie et la qualité de la vie ont été ajoutées . L'état général a été représenté par un score comprenant des variables spécifiques de la maladie et socio-personnelles allant de 0 ( très mal ) à 14 ( très bien ) points . Dans l'étude pilote le passage duodénal n'a pas montré d'avantage concernant la réabsorption intestinale . Le malaise post-opératoire essentiel a été l'insuffisance de l'absorption calorique . L'opération radicale a une mortalité hospitalière de 16 % et comprend un taux de complication de 37 % . Le cancer de l'estomac est de prognostic peu favorable . Seuls 15 ( 39 % ) des 38 patients ont survécu la première année dans le étude r and omisée mais la probabilité de survie après HLR ( 58 % ) dépasse celle après EJ ( 24 % ) ( p<0.05 ) . La f aim et l'appétit ont été sévèrement réduits pendant les 6 premiers mois post-opératoires . Comparée à la situation pré-opératoire , la quantitié de nourriture a diminué d'au moins 50 % ce qui correspond à une perte de poids de 7 kilos en moyenne . Les malades qui ne survivent pas la première année subissent une perte importante et irréversible de leur qualité de vie . Ceci nous amène à dire qu'ils ne profitent pas de l'intervention chirurgicale contraitement aux autres qui regagnent une qualité de vie égale ou même supérieure aux valeurs pré-opératoires . Au total nous pouvons affirmer que ce sont essentiellement les patients opérés qui ont subi une HLR qui survivent un an ou plus et qui tirent profit de la gastrectomie totale . ResumenEste es un informe provisional de un ensayo clínico aleatorizado para comparar la esofagoyeyunostomía ( EY ) con la bolsa de Hunt-Lawrence-Rodino ( HLR ) como técnicas de reconstrucción gástrica después de gastrectomía total con linfadenectomía sistemática como tratamiento del cáncer gástrico . El ensayo aleatorizado fue precedido de un estudio piloto para comparar el procedimiento de interposición de Longmire-Gütgemann con la HLR . El estudio piloto incluyó 7 pacientes y el ensayo aleatorizado 38 pacientes ( 60 fueron planeados ) . Las principales variables analizadas en el estudio piloto fueron la resorción de alimentos , la ingesta calórica , y el peso corporal . En el ensayo aleatorizado fueron analizadas , además , la probabilidad de supervivencia y el estado de bienestar general ( calidad de la vida ) . Se construyó un puntaje a partir de variables específicas de la enfermedad y sociopersonales para calificar el estado de bienestar general ( calidad de la vida ) entre 0 ( peor ) y 14 (óptimo).En el estudio piloto el paso a través del duodeno no demostró ventaja significativa en cuanto a la resorción intestinal . La principal alteración postoperatoria fue la ingesta alimenticia insuficiente . A pesar de una operación radical , una mortalidad de 16 % , y una tasa de complicaciones de 37 % , el cáncer gástrico mantiene un pronóstico poco favorable . En el ensayo aleatorizado sólo 15 ( 39 % ) de 38 pacientes sobrevivían 1 año después de la operación , con una probabilidad de supervivencia mayor ( 58 % ) después de la HLR que después de la EY ( 24 % ) ( p<0.05 ) . El hambre y el apetito aparecieron notoriamente disminuidos durante el primer semestre después de la operación . La ingesta de alimento fue menos de la mitad del valor preoperatorio , lo cual se manifestó en una disminución del peso corporal de 7 kg en promedio . Los pacientes que murieron en el curso del primer año después de la gastrectomía total exhibieron una disminución importante e irreversible de la calidad de la vida ( cerca de 7 puntos ) y no demostraron beneficio objetivo de la operación , en comparación con los que sobrevivieron tal período , quienes recuperaron una buena calidad de la vida con valores iguales o superiores a los preoperatorios , especialmente después de HLR.Nuestra conclusión es que los pacientes sometidos al procedimiento HLR que sobreviven por lo menos 1 año , se benefician de la gastrectomía total en lo relativo a la calidad de la vida Background The double tract ( DT ) method was compared with the Roux-en-Y ( R-Y ) method to identify the optimal reconstruction procedure after total gastrectomy for patients with gastric cancer . The DT reconstruction is as simple as the R-Y , and it can be safely performed even after total gastrectomy . However , these have been no studies evaluating the usefulness of DT reconstruction in comparison to R-Y reconstruction . Methods A group of 44 patients with gastric cancer were intraoperatively r and omized for R-Y ( n = 23 ) or DT reconstruction ( n = 21 ) after total gastrectomy ( TG ) . Body weight , food intake , nutritional conditions , and quality of life ( QOL ) were determined at 3 and 12 months after the operation . This study is registered with Clinical Trials.gov , no. NCT00746161 . Results Food intake significantly decreased soon after the operation . No differences were observed between the DT and R-Y groups . The body weight decreased throughout the ensuing period ( P < 0.05 ) and thereafter gradually recovered . However , no differences were observed between the two groups . Among the nutritional laboratory parameters , serum prealbumin , retinol-binding protein , total cholesterol , and triglyceride were decreased soon after the operation . The changes of those parameters were not substantially different between the two groups . The postoperative QOL was evaluated , and no differences were observed between those groups . Conclusions There were no particular advantages in the DT method after TG in comparison to the simple R-Y method in terms of body weight , QOL , and nutritional conditions , suggesting that the DT method might not be recommended after TG for patients with gastric cancer Out of 74 consecutive patients with gastric carcinoma only 39 patients fulfilled the inclusion criteria for this r and omized study . These patients were divided into two groups intraoperatively , 21 were reconstructed with and 18 without performing a stapled interposed jejunal pouch .  Quality of life was evaluated using Spitzer 's QL index and Cuschieri 's assessment for 6 months . Spitzer 's QL index showed -- as expected -- no differences concerning the specific reconstruction in gastrointestinal complaints , whereas Cuschieri 's assessment revealed an advantage in the pouch group . Cuschieri 's assessment needs to be vali date d by larger comparable groups to prove its suitability for the determination of specific gastrointestinal complaints concerning the type of reconstruction in gastric cancer patients BACKGROUND Although more than 50 methods of  gastric replacement after total gastrectomy have been used , none of them has demonstrated a substantial nutritional advantage . The Roux-en-Y esophagojejunostomy is still the preferred type of reconstruction , more because of its simplicity than the lack of postpr and ial disturbances . STUDY DESIGN A r and omized controlled trial was conducted to compare two reconstructive procedures , Roux-en-Y esophagojejunostomy ( n = 24 ) and Hunt-Rodino-Lawrence pouch ( HRL , n = 24 ) , by evaluating nutritional status ( body weight , arm circumference , and serum nutritional parameters ) , nutritional habits ( number of meals , energy intake , and postpr and ial disturbances ) , and emptying time of the jejunal loop . RESULTS Twenty-seven patients were studied two years after operation ( 12 had undergone Roux-en-Y and 15 had undergone HRL ) . No difference was found in either postoperative morbidity or mortality , emptying time , frequency of meals , or variation of body weight . Postpr and ial disturbances were more frequent in patients having Roux-en-Y. In a subset of patients , there was a correlation between nutrient intake and change of body weight , but not between nutrient intake and type of reconstruction . CONCLUSIONS The simple use of a reservoir such as the HRL pouch after total gastrectomy is of no benefit to the patient as compared with the Roux-en-Y reconstruction Patients with carcinoma of the stomach who underwent curative resection were r and omized to total gastrectomy ( n = 49 ) , total gastrectomy and an S‐shaped gastric substitute ( n = 28 ) or subtotal gastrectomy ( n = 12 ) ; all had a Roux‐en‐Y reconstruction . The gastric substitute and gastric remnant allowed a volume of 400–500 ml to be installed without increments in basal pressures . The corresponding volume in the Roux limb was 100 ml . Energy intake was approximately 120 kJ/kg preoperative weight per day 3 months after operation , and then remained constant . Patients who had subtotal gastrectomy ate less ( 91.7 kJ/kg preoperative weight ) 3 months after operation , but thereafter increased their intake . Patients allocated to have a gastric pouch or subtotal gastrectomy complained more frequently of adverse postpr and ial symptoms ( P < 0.03 ) as a major cause of reduced calorie intake . The construction of a gastric reservoir did not improve nutritional adaptation after surgery for gastric carcinoma Controversial results have been reported regarding the importance of the duodenal food passage after total gastrectomy . There are a number of experimental and clinical studies showing an advantage for the jejunal interposition between esophagus and duodenum . Others favor the Roux-en-Y reconstruction , as it is technically less dem and ing . The purpose of this study was the r and omized comparison between two major reconstruction principles after total gastrectomy for gastric cancer ( i.e. , jejunal interposition with pouch versus Roux-en-Y pouch reconstruction ) . A group of 120 patients with gastric cancer were r and omized and operated on during a 5-year period according to st and ardized operative protocol s , using either a jejunal interposition with pouch ( JIP ) or the Roux-en-Y reconstruction with pouch ( RYP ) . Endpoints of this study were operation time , intra- and postoperative problems and complications , patients ' body weight , functional assessment , and quality of life . Of the 120 patients , 14 had to be withdrawn during the operation because only the Roux-en-Y reconstruction was technically possible . Finally , 53 patients with JIP  were compared with 53 patients with RYP for the perioperative course . There were no significant differences between the two procedures ( 
    Output:
    
The results of the meta-analyses showed that operative mortality and morbidity were not significantly different between the two procedures ( preservation vs. non-preservation of duodenum ) .
However , operative time was considerably prolonged by preserving the duodenal passage .
Patients in the preservation group had an improved nutritional parameters ( body weight , levels of serum iron and hemoglobin ) in the short term ( < 6 months ) after surgery .
Beneficial effect on preventing postgastrectomy symptom ( heartburn , dumping syndrome ) was not found by maintaining the duodenal passage throughout a 2-year follow-up .
Moreover , a qualitative measurement showed that no significant quality of life improvement for patients with a preserved duodenal passage .
Conclusion This systematic review failed to demonstrate obvious advantage in preserving duodenal passage after total gastrectomy