Total gastrectomy for gastric cancer: the rationale for J-pouch reservoir.
This prospective study examines the results of total gastrectomy in 56 consecutive patients (38 males and 18 females) and compares Hunt-Limo-Basto J-pouch reconstruction (23 patients) with simple oesophago-jejunostomy (33 patients). There was no difference in morbidity and mortality between the two groups, which are fairly well-matched proportionately in age, concomitant disease and stage of disease. There was, however, a male predominance in the non-pouch group. Anastomotic leak occurred in only one patient with gastric reconstruction while one duodenal stump leak developed in the non-pouch patient. Construction of the stapled J-pouch extended the operation by a mean time of 14 min. The only advantage of the J-pouch is that it facilitates introduction of a larger diameter stapler for oesophago-jejunostomy. The nutritional benefit remains uncertain.
Chua
C L
CL
Department of Surgery, Tan Tockseng Hospital, Singapore.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate