Common Reconstruction Methods Research Articles

Reconstructive Option of Extensive Head and Neck Defects in Cancer Surgery

Aim of the study was to present the best methods for reconstruction of extensive defects after removal of the head and neck cancer. Key to success of reconstrucive surgery is choosing an appropriate option that aim at single stage replacement of lost tissue and provide the integrity, function and aesthetic outcome in a perfect balance. This descriptive study was carried out between march 2009. And march 2013. at the Clinic of Maxillofacial surgery, Clinical center of University of Sarajevo, Bosnia and Herzegovina. A total number of 483 patients with extensive defects were included. Most of the patients 421 (87%) were males. The diagnosis of squamous cell carcinoma was present in 355 (73.5%) cases wich was statistically significant. Pectoralis major myocutaneous flap was the most common reconstruction method, in 267 (55.3%) cases. Second common method used were local flap 147 (30.4%), then temporal flap 36 (7.5%). Infrahyoid flap, latissimus dorsi, radial forearm free flap and free fibula graft were also used. The prevalence ofpectoralis major myocutaneous flap was statistically significant. The most comon complication among donor and recipient side was hematoma. Total flap necrosis occured in 9 (1.9%) patients. Comparing donor and recipient side in common complications there were no statistical significant difference. Wich technique for closure to choose depends on the complexity of defect. The pectoralis major myocutaneous flap continues to be the most universal flap in head and neck reconstruction.

군용 인지 무선 네트워크 환경에서 점대점 통신을 위한 신속하고 신뢰성 있는 동적 공통 채널 설정 및 복원 방법

인지 무선 환경에서의 부 사용자들은 주 사용자가 일시적으로 사용하지 않는 채널을 기회적으로 이용하여 통신을 수행한다. 이러한 통신은 부 사용자 상호간에 접근이 가능한 공통 채널을 통해 이루어지는데, 부 사용자들의 통신을 위한 공통 채널은 주 사용자의 채널 사용 현황을 바탕으로 동적으로 변경될 수 있다. 최근 인지무선통신을 위한 연구가 많이 진행 되고 있으나, 공통 채널을 구성하기 위한 세부적인 절차에 대한 연구가 부족한 실정이다. 본 논문에서는 인지무선 네트워크 환경에서 군사용 무전기의 점대점 통신을 위한 신속하고 신뢰성 있는 동적 공통 채널 설정 및 복원 방법에 대한 방법과 절차를 제안하고, 공통 채널 설정과 복원 과정을 위한 패킷 교환 시간, 채널 요청 대기 시간, 랑데부 시간과 같은 시간 파라미터들을 고려하여, 각각의 세부적인 절차들을 기술하였다. 또한, 수치 해석을 통해서 채널 설정 및 복원 지연 시간과 처리량 등을 도출하여 제안된 방법의 성능을 평가하였다. In cognitive radio networks, secondary users are allowed to utilize the channels currently not occupied by primary users opportunistically. Secondary users can communicate with each other using the commonly available channels (common channels) which may change dynamically based on the activity of the primary users. Even though many studies have dealt with cognitive radio behaviors, the detailed procedures for common channel configuration have not been paid much attention. In this paper, the fast and reliable dynamic common channel setup and reconstruction method for the point-to-point communications in military cognitive radio networks is proposed. The detailed time parameters are considered for common channel setup and reconstruction, such as the packet exchange time, channel request waiting time, and rendezvous time. Through numerical analyses, the delay and throughput performance of the proposed method is derived and evaluated.

Reconstruction of Large Anterior Scalp Defects Using Advancement Flaps

Reconstruction of the scalp may be challenging for reconstructive surgeons because of the special anatomic structure of the scalp and underlying skeleton. Anterior scalp defects especially deserve special care for pleasant hairline re-creation and redirection of hair follicles. Local transposition or rotation flaps are the most common reconstruction methods for moderate or large anterior scalp defects. However, currently available techniques usually require multiple stages for completion of the reconstruction without alopecia.In this study, we report our experience with unilateral or bilateral advancement flaps for moderate or large anterior scalp defect reconstructions. Eight patients who had anterior scalp defect of varying etiology were presented. The defect size ranged between 3 × 5 and 8 × 12 cm. The average size of the defect was 53. 3 cm. The defects were located on the frontoparietal area of the scalp in 3 patients and frontal area in 5 patients. Unilateral advancement flap was used in four cases. All the flaps survived except in one patient who had partial flap loss. Based on our experience, we suggest that large scalp defects located especially on the frontal or frontoparietal area can be reconstructed with unilateral or bilateral scalp advancement flaps in one stage without the need for multiple surgeries.

Vaginal Reconstruction Following Radical Surgery for Colorectal Malignancies: A Systematic Review of the Literature

Vaginectomy is frequently indicated to ensure an adequate resection in rectal cancer. This paper reviews the success, complications, and functional results after various methods of vaginal reconstruction following resection for rectal tumors. A systematic review of the literature was performed by using the MEDLINE database, Embase, and the Cochrane library (1990-2010). Eighteen papers were available to review. Fifty percent of all women who received a neovagina following vaginectomy returned to sexual activity postoperatively. The rectus abdominis myocutaneous (RAM) flap remains the most common method of vaginal reconstruction after surgery for colorectal cancer. Advantages include low operative morbidity, a wide arc of rotation, and ease of harvest. Alternatives to flap reconstruction of the vagina have limited indications because of higher morbidity rates. Preferred techniques for vaginal reconstruction following vaginectomy with colorectal cancer resection include RAM flaps for partial posterior vaginal defects and bilateral Gracilis myocutaneous flaps for complete vaginal excisions.

Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan

The Japanese Society for the Study of Postoperative Morbidity after Gastrectomy conducted a nationwide questionnaire survey to clarify the current status of reconstruction after gastrectomy. One hundred and forty-five institutions (66%) responded to the survey. The questionnaire dealt with the reconstruction after a distal gastrectomy, pylorus-preserving gastrectomy (PPG), total gastrectomy, and proximal gastrectomy. The most common method of reconstruction after distal gastrectomy was Billroth I in 112 institutions (74%), and Roux-en-Y (RY) in 30 (21%). Seventy-seven institutions (53%) responded to the PPG questions. The lengths of the antral cuff were widely distributed among the institutions. Segmental gastrectomy was performed by 23 institutions for limited cases. The most common method of reconstruction after total gastrectomy was RY in 138 institutions (95%). Reconstruction with a pouch after total gastrectomy was done in 26 institutions (18%). The most common reconstructions after proximal gastrectomy were esophagogastrostomy in 69 institutions (48%), jejunal interposition in 41 (28%), double tract in 19 (13%) and pouch reconstruction in 6 (7%). Although most Japanese surgeons are concerned about the revised methods of reconstruction and quality of life after gastrectomy, surgeons have not yet reached a full consensus on these issues.

Application of artificial prosthesis reconstruction techniques in malignant tumors around the knee joint

About 30% of all malignant bone tumors occur in the distal femur and proximal tibia, and 70% of osteosarcomas, the commonest primary malignant bone tumor, occur around the knee joint 1 . In the last 30 years, with the progress and development of imaging techniques, combination therapy and surgical techniques, limb salvage surgery has gradually replaced amputation and become the primary surgical method for managing malignant bone tumors in the extremities. There are many reconstruction methods for bone defects after resection of malignant bone tumors around the knee joint, namely: (i) vascularized fibular grafts; (ii) osteoarticular allografts; (iii) inactivation and reimplantation; (iv) artificial prosthesis replacement; (v) allograft‐prosthesis compound reconstruction. The decision as to which reconstruction technique to use depends on the nature of the tumor, its anatomical site, extent of invasion, size of bone defect and clinical condition of the patient. The Massachusetts General Hospital has done extensive research on the application of massive bone allograft over a long period, and in 1996 reported 718 cases of bone allograft after resection of bone tumors in the extremities and reconstruction (including 386 cases of osteoarticular allograft). Their postoperative fracture rate was 19%, nonunion 17%, infection 11% and instability 6% 2 . In 2004, they reported the evolution of reconstruction techniques for limb salvage following resection of bone tumors during the eight years between 1996 to 2004: the number of artificial prosthesis reconstructions had increased by 40%, while bone allografts had decreased by 50% over the same period. These differences can be explained by the following: for bone allografts the non‐weight‐bearing period is longer and nonunion and infection rates higher; whereas artificial prosthesis reconstruction has the advantages of early weight‐bearing, good stability and few early complications 3 . Nowadays, artificial prosthesis reconstruction has become a common reconstruction method for bone defects after resection of malignant tumors around the knee joint.

Successful reconstruction of scalp and skull defects: Lessons learned from a large series

To provide a framework for the management of scalp and skull defects. Retrospective chart review. Two tertiary care hospitals. Fifty-six consecutive patients who underwent reconstruction of scalp and/or skull defects with free flaps, rotational skin/fascia flaps, skin grafts, and implants. Defects closed primarily and those of the lateral temporal bone and skull base were excluded. Sixty-two reconstructions were performed. Treatment of skin cancers and intracranial tumors necessitated 31 (50%) and 22 (35%) of the reconstructions, respectively. Defects included partial-thickness soft tissue (9, 15%), full-thickness soft tissue (28, 45%), full-thickness soft tissue and skull (17, 27%), and full-thickness soft tissue, skull, and dura (8, 13%). Radiation or prereconstruction wound breakdown or infection was involved in 33 (53%) and 25 (40%) of cases, respectively. The most common method of reconstruction was free tissue transfer (27, 44%) followed by local skin (15, 24%) or fascia (9, 15%) flaps. There was a 15% (9/62) complication rate; 89% (8/9) of these occurred in radiated tissues and 44% (4/9) occurred in smokers. Seven of the nine patients with complications (78%) were managed with local wound care and/or removal of an implant, whereas 2 (22%) required a second reconstructive procedure. All patients ultimately achieved a safe outcome with no infection and no bone or dural exposure. In addition to defect location and extent, availability of surrounding tissue and wound healing characteristics direct reconstruction. Patients who receive radiation therapy are at increased risk of complications. Use of vascularized tissue is critical for successful management, making local flaps and free tissue transfer the mainstay of reconstruction.

Accelerated takedown of the paramedian forehead flap at 1 week: Indications, technique, and improving patient quality of life

The paramedian forehead flap (PFF) is a common method of reconstruction for large nasal defects. Generally, surgeons divide this flap at 3 weeks. This delay can result in a significant decrease in the quality of life for these patients. We sought to describe the indications and technique for trunk division at 1 week after PFF reconstruction, and to evaluate the clinical outcomes. This was a case series of consecutive patients undergoing primarily nasal defect reconstruction by PFF repair during the past 6 years. We explored medical record review of associated complications, patient rating of impact on quality of life and final results of repair, and patient preferences regarding time to flap division. A total of 26 patients underwent accelerated trunk division at a mean of 7.2 days. Of these, 27% had a history of tobacco use, 23% were diabetic, and 19% had cartilage grafts used in their repairs. None developed necrosis and other complications were minor. Most patients considered their trunk very disfiguring, preventing them from daily activities. This was especially true for those younger than 70 years. Of all patients, 94% preferred trunk division at 1 week, rather than 3 weeks. Retrospective study design and number of patients were limitations. PFF trunk division at 1 week is safe and effective for resurfacing of large nasal defects, including those reconstructions that require cartilage. Younger and healthier patients may be the most ideal candidates for accelerated division given the greater negative impact of an intact trunk on their lives.

An Investigation of the Application of Laser-Assisted Indocyanine Green Fluorescent Dye Angiography in Pedicle Transverse Rectus Abdominus Myocutaneous Breast Reconstruction

Pedicle transverse rectus abdominus myocutaneous (pTRAM) flaps remain the most common method of autologous tissue breast reconstruction. Using pTRAM flaps, complications often arise postoperatively, secondary to inadequate circulation. Tissues from distant angiosomes are associated with poorer perfusion, but this differs among patients. Many modalities have been used to reduce the risk of complications, but none have achieved widespread application. The authors believe that laser-assisted indocyanine green fluorescent dye angiography (LA-ICGA) can potentially reduce the risk of complications. In two routine, single-pedicle, ipsilateral pTRAM flaps, LA-ICGA imaging was performed following the division of the distal rectus muscle and deep inferior epigastric pedicle. The resulting images were used to guide design of the flap and debridement. In case 1, good perfusion was observed in zone 1 and part of zone 2. In case 2, good perfusion was observed in zone 1 and 50% of zone 3, with little perfusion in zone 2. In both cases, tissues with poor perfusion were debrided before transfer and inset. In both patients, there were no issues with wound healing, tissue necrosis or fat necrosis. The variability of perfusion of the pTRAM flap among individuals is well appreciated. LA-ICGA helped to determine the limits of good perfusion and, therefore, the limits of tissue to be preserved for transfer and inset. This helped to avoid harvesting poorly perfused tissue that would have almost certainly experienced necrosis and, ultimately, would have reduced the risk of postoperative complications.

Transport Properties of Stochastically Reconstructed Porous Media with Improved Pore Connectivity

Results from stochastic reconstruction of porous solids and from a direct comparison of calculated and experimental effective transport properties are presented. Eight porous solids of different microstructures were selected to evaluate the performance of two reconstruction methods based on simulated annealing. The common method was constrained by the two-point probability function and the lineal-path function for the void phase, whilst the constraints of our new method were further supplemented by the lineal-path function for the solid phase and by two adjustable parameters. The new method was capable of reproducing the void and solid phases as large clusters spanning the entire replicas. Non-percolating clusters formed minor volume fractions of both phases. Although the common method reproduced the microstructures quite well, their pore space connectivity was significantly poorer. Therefore, effective permeability, effective ordinary diffusivity, and effective Knudsen diffusivity calculated for the replicas obtained using the new method were always much greater than the same quantities related to the common reconstruction method. For most of the porous solids, values of the effective properties calculated on the basis of the new reconstruction method better matched their experimental counterparts than the corresponding values derived from the microstructures reproduced using the common reconstruction method.

Fast tomographic reconstruction on multicore computers

Tomo3D implements a multithreaded vectorized approach to tomographic reconstruction that takes full advantage of the computer power in modern multicore computers. Full resolution tomograms are generated at high speed on standard computers with no special system requirements. Tomo3D has the most common reconstruction methods implemented, namely weighted Back-projection (WBP) and simultaneous iterative reconstruction technique (SIRT). It proves to be competitive with current graphic processor unit solutions in terms of processing time, in the order of a few seconds with WBP or minutes with SIRT. The program is compatible with standard packages, which easily allows integration in the electron tomography workflow.

The history of pediatric airway reconstruction

To review the history of pediatric laryngotracheal reconstruction and to highlight those who made major contributions in the field. Retrospective literature review. A literature search using the PubMed database from 1950 to the present. Earlier references were obtained from the Adams Center, the National Library of Medicine, and Virginia Commonwealth University Library. A total of 20 articles were identified. The articles reported 274 airway reconstructions of which 79% were in children. Pre-1935 infection was the leading cause of laryngotracheal stenosis. Laryngostomy, pioneered by Chevalier Jackson, was the most common method of reconstruction. Between 1935 and 1970, trauma was the predominant cause of laryngotracheal stenosis. The most common procedure was the anterior/posterior cricoid split or Rethi procedure. It marked the introduction of bony grafts in laryngotracheal surgery as pioneered by Looper. Post-1970, prolonged intubation in neonates was the most common cause of subglottic stenosis. The field was revolutionized by the work of Evans and Cotton, with widespread use of costal cartilage grafts and laryngotracheoplasty leading to a decannulation rate of over 90%. Advances included decreased morbidity, tolerability, shorter recovery time, and fewer stages of reconstruction. The pioneering work of many leaders in the field of airway reconstruction over the last 100 years has resulted in a number of effective airway reconstructive procedures that have led to the majority of children being successfully decannulated. In the future, more extensive surgeries, such as tracheal transplantation, may address the small number of children who presently cannot be decannulated.

The Pedicled Transverse Rectus Abdominis Myocutaneous Flap: Indications, Techniques, and Outcomes

Breast reconstruction has evolved significantly during its short, 40-year history. What began as limited reconstruction through the use of local skin flaps has now become an entire array of procedures including novel autologous flaps and new techniques in implant/expander use. Throughout this evolution, the primary goal of reconstruction has always remained the same: to recreate the most natural breast mound possible. In the early 1980s, autologous tissue was at the forefront of breast reconstruction, and the pedicled transverse rectus abdominis myocutaneous (TRAM) flap quickly became the reconstructive method of choice for tissuebased reconstruction. Despite the advent of microsurgery, advances in perforator-based flap design, and increasing procedural complexity, the pedicled TRAM flap is still one of the most common methods of autologous reconstruction performed today. In properly selected patients, the pedicled TRAM flap can provide a natural appearing breast mound with limited morbidity and superior patient satisfaction.

The augmented TRAM flap: a technique for the large-breasted patients

The transverse rectus abdominis myocutaneous (TRAM) flap is the most common method of autogenous breast reconstruction. In high-risk patients, a reliable and bulky flap is needed to achieve breast symmetry and a mound together with durable satisfactory projection. The purpose of this study is to look into the use of contralateral zones of the pedicled TRAM flap to improve flap survival and to reduce the incidence of fat necrosis in order to achieve good cosmetic results. Seven obese large-breasted patients of cup size C and above who underwent primary breast reconstruction by the same surgeon are presented. In each case, all the four zones of the TRAM flap were used to achieve symmetry of the reconstruction. Patients had mastectomy with or without axillary clearance. The pedicled TRAM flap was elevated and the other side was raised as a perforator flap for microvascular augmentation. The perforator vascular pedicle was anastomosed to the thoracodorsal vessels in all cases. The anterior rectus sheath was repaired with a mesh in all cases. All the flaps were coned to achieve a good projection. All flaps survived with no complications or loss. All patients were satisfied with the outcome. One of our patients developed an abdominal bulge that was treated conservatively. Microvascular augmentation improved survival of zones III and IV of the TRAM flap, exemplified by flap survival and no incidence of fat necrosis. It is a good reconstructive tool to achieve breast volume, symmetry, and projection. In addition, it reduces the need of secondary breast surgery for the contralateral breast in the future.

Measurements of the characteristics of spray droplets using in-line digital particle holography

In-line digital particle holography is applied to measure the characteristics of spray droplets. Common reconstruction methods were considered and the best one was selected. Several important parameters at the time of hologram recording, such as the object distance and the region of laser beam used, are discussed. The feasibility of the correlation coefficient (CC) method for focal plane determination of 3-D droplets was verified. A double exposure hologram recording system with synchronization system for time control was established, and two digital spray holograms were obtained in a short time interval. For post-processing of reconstruction images, the two-threshold and the image segmentation methods were used in binary image transformation. Using the CC method and some image processing techniques applied to droplets in each double exposure image, the spatial positions of droplets used to evaluate the three dimensional droplet velocities were easily located, which proved the feasibility of in-line digital particle holographic technology as a good measurement tool for spray droplets.

Computational Patient-Specific Models Based on 3-D Ultrasound Data to Quantify Uterine Arterial Flow During Pregnancy

Information on uterine blood flow rate during pregnancy would widely improve our knowledge on feto-placental patho-physiology. Ultrasonographic flow rate evaluation requires the knowledge of the spatial velocity profiles throughout the investigated vessel; these data may be obtained from hemodynamic simulations with accurate computational models. Recently, computational models of superficial vessels have been created using 3-D ultrasound data; unfortunately, common reconstruction methods are unsuitable for the uterine arteries due to the low quality achievable of imaged deep vessels. In this paper a simplified spline-based technique was applied to create computational models for patient-specific simulations of uterine arterial heamodynamics. Moreover, a novel method to quantify the uterine flow rates was developed based on echo-Doppler measurements and computational data. Preliminary results obtained for four patients indicated a quite narrow range for the blood flow rate through the main uterine artery with large variability in the flow split between corporal and cervical branches. Furthermore, parabolic-like velocity profiles were obtained in the branching region of the different patients, suggesting a clinical use of averaged, not patient-specific, spatial velocity distribution coefficients for the blood flow rate calculation. The developed reconstruction method based on 3-D ultrasound imaging is efficient for creating realistic custom models of the uterine arteries. The results of the fluid dynamic simulations allowed us to quantify the uterine arterial flow and its repartition in normal pregnancies.

Optimizing Pedicled Transverse Rectus Abdominis Muscle Flap Breast Reconstruction

With improved detection and genetic screening for breast cancer, increasing numbers of patients are choosing mastectomy and immediate breast reconstruction. Advances in breast reconstruction and mastectomy techniques over the last 25 years have increased expectations for breast reconstruction. The purpose of this review is to describe the role of the pedicled transverse rectus abdominis muscle (TRAM) flap in modern breast reconstruction.The pedicled TRAM flap is the most common method of autologous breast reconstruction. TRAM flap reconstruction involves the transfer of lower abdominal skin and subcutaneous fat based on the superior epigastric vessels. Common risk factors for complications from pedicled TRAM flap reconstruction include smoking, obesity, and postoperative radiotherapy. Patients with these risk factors are often candidates for a vascular delay procedure whose purpose is to enhance the blood flow within the TRAM flap.Despite advances in free flap breast reconstruction, pedicled TRAM flap breast reconstruction remains an excellent option for unilateral breast reconstructions. Unlike microsurgical breast reconstruction, the pedicled TRAM flap does not require sophisticated postoperative monitoring and can be performed efficiently in any hospital setting. Furthermore, with the addition of a vascular delay procedure, pedicled TRAM reconstructions can be safely performed even in traditionally "high risk" patients.

Breast reconstruction with the TRAM flap: Pedicled and free

Breast cancer is a ubiquitous disease affecting one in seven women. While breast conservation techniques are available for local control of the disease for many patients, not all patients are good candidates for these techniques. Mastectomy, therefore, remains a common method of breast cancer treatment. Methods of reconstruction include implant reconstruction and autogenous reconstruction. The advantages of autogenous reconstruction include the creation of a soft, ptotic breast mound, which tends to match a native contralateral breast both in and out of bra support. Autogenous reconstructions do not tend to change with time and usually do not require periodic revision as seen in implant reconstructions. The most common method of autogenous reconstruction is the TRAM flap, either pedicled or free. The TRAM flap employs the redundant excess lower abdominal tissue typically removed during a cosmetic abdominoplasty. This tissue is brought to the mastectomy defect as a pedicled flap, passing subcutaneously from the upper abdomen and into the defect site. The pedicled flap is based upon the superior epigastric vessels. A free TRAM is harvested with the overlying muscle and the attached inferior epigastric vessels. This flap is completely separated from the abdomen and brought to the chest defect where it is anastomosed to either the thoracodorsal or internal mammary vessels. The donor defect within the abdominal wall is repaired with an inlay mesh with both the pedicled and free techniques. Patient selection criteria usually help determine which technique is used. The advantage of the free flap technique is improved blood supply to the skin island. The free flap, therefore, is used in patients at higher risk for partial flap loss with the pedicled technique. Such high-risk patients include smokers, the obese, patients with significant medical comorbidities, and patients with prior abdominal surgery. Patients without these risk factors can be expected to achieve good results with either the pedicled or free flap technique. Autogenous breast reconstruction with the TRAM flap achieves long lasting satisfactory results in most patients with the creation of a soft, naturally ptotic breast mound, which typically matches well a contralateral native breast.

Signal and noise of Fourier reconstructed fMRI data

In magnetic resonance imaging, complex-valued measurements are acquired in time corresponding to spatial frequency measurements in space generally placed on a Cartesian rectangular grid. These complex-valued measurements are transformed into a measured complex-valued image by an image reconstruction method. The most common image reconstruction method is the inverse Fourier transform. It is known that image voxels are spatially correlated. A property of the inverse Fourier transformation is that uncorrelated spatial frequency measurements yield spatially uncorrelated voxel measurements and vice versa. Spatially correlated voxel measurements result from correlated spatial frequency measurements. This paper describes the resulting correlation structure between voxel measurements when inverse Fourier reconstructing correlated spatial frequency measurements. A real-valued representation for the complex-valued measurements is introduced along with an associated multivariate normal distribution. One potential application of this methodology is that there may be a correlation structure introduced by the measurement process or adjustments made to the spatial frequencies. This would produce spatially correlated voxel measurements after inverse Fourier transform reconstruction that have artificially inflated spatial correlation. One implication of these results is that one source of spatial correlation between voxels termed connectivity may be attributed to correlated spatial frequencies. The true voxel connectivity may be less than previously thought. This methodology could be utilized to characterize noise correlation in its original form and adjust for it. The exact statistical relationship between spatial frequency measurements and voxel measurements has now been established.

Subjective and Functional Results after a Proximal Gastrectomy: Prospective Study for Comparison of Reconstruction Procedures

Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients.