[Digestive continuity, after total gastrectomy for cancer, via the interposition of a jejunal loop].
The total gastrectomy, as known can expose to some sequences which form on a pathophysiologic and clinic plain syndrome of "AGASTRIC". The most paradigmatic of these disturbances are the weight loss, the pain, the dyspepsia, the anorexia, can be erroneously interpreted as a recurrence of the neoplasm illness. On the base of these disturbances, there are some pathophysiological alterations associated to the resection. The postprandial distension syndrome, the dumping, the diarrhea, the anemia, can be relieved by an appropriated hygienic-diet therapy. The reflux of biliopancreatic secretion into the esophagus, the disturbances related to the duodenal exclusion, the accelerated transit can be loosed or reduced by a correct technic, while the cloridopeptic deficiency is obviously unresolvable. From 1981 till 1988, 43 patients were submitted to a total gastrectomy for adenocarcinoma (29 M, 14 F), having a middle age of 62 years: 30 with a radical intent (Ro), and 13 palliative. Besides 10 of the Ro group were submitted to a enlarged intervention. The digestive continuity was renewed through an interposition of isoperistaltic jejunal loop according Mouchet-Camey in 23 cases, by use of a dysfunctional loop according Roux en-Y in 5, and by esophagus-jejunal T-L anastomosis such omega, according Horloff in 2 cases. There were registered one decrease for A.R.D.S. All the patients were been followed according the follow-up protocol, for monitoring neoplasm evolution of the illness and the eventual metabolic-functional disturbances. In the periodic postoperative control all the patients with Mouchet-Camey reconstruction had no evidenced dumping syndrome, neither cases of malabsorption of the essential nutritive principles, with constant recover of the weight.(ABSTRACT TRUNCATED AT 250 WORDS)
D'Amico
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Istituto di Clinica Chirurgica II, Università degli Studi di Padova.
Ranzato
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R
D000230:Adenocarcinoma / Q000601:surgery*; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008223:Lymphoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000601:surgery*
La continuità digestiva, dopo gastrectomia totale per cancro, mediante interposizione di ansa digiunale.