Reconstruction of the digestive tract after total gastrectomy.
Reconstruction of the digestive tract after total gastrectomy should be safe and give the patient maximal comfort. Dehiscence of the esophago-enteral anastomosis is the main cause of operative mortality. Stapling and jejunoplication procedures offer the best chances of success. A Roux-en-Y esophagojejunostomy is readily carried out in patients with malignant disease, and avoids distressing reflux esophagitis, which constitutes a major cause of morbidity. The construction of a gastric reservoir has been advocated to prevent malnutrition, weight loss and other functional complaints. This matter is still the subject of much debate and requires further prospective studies. A personal retrospective evaluation of 23 patients provided with a Lygidakis pouch after total gastrectomy shows that this procedure can be performed with an acceptable mortality rate (8.7%). The clinical results look promising as most of the patients studied one year after the operation had no functional complaints and their weight had stabilized.
Hubens
A
A
Antwerp University Affiliated Hospital Group.
van Hee
R
R
van Vooren
W
W
Peeters
R
R
D000713:Anastomosis, Roux-en-Y; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D009748:Nutrition Disorders / Q000517:prevention & control; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*