Clinical outcome and quality of life after gastric and distal esophagus replacement with an ileocolon interposition.
Mainly because of the loss of reservoir function, loss of sphincter function, and exclusion of the duodenal route, patients who undergo gastrectomy suffer from many adverse effects postoperatively. The ileocecal interpositional graft is an attractive method to use as a gastric substitute after gastrectomy and distal esophagectomy. A pedunculated ileocecal graft is placed between the esophagus and the duodenum. The cecum acts as a reservoir while the ileocecal valve protects against enteroesophageal reflux. The duodenal passage is also preserved. Fourteen patients underwent this operation. The technique-related morbidity was low and the quality of life was good. During a mean follow-up of 6 months, no evidence of severe dumping syndrome or reflux esophagitis was observed. Further prospective randomized studies are warranted to compare this technique with the standard methods of gastric reconstruction.
Metzger
J
J
Surgical Department, University Hospital of Basel, Basel, Switzerland. MetzgerJ@ubaclu.unibas.ch
Degen
L
L
Beglinger
C
C
von Flüe
M
M
Harder
F
F
D000328:Adult; D000368:Aged; D002432:Cecum / Q000637:transplantation; D003106:Colon / Q000637:transplantation*; D004377:Dumping Syndrome / Q000517:prevention & control; D004386:Duodenum / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D004942:Esophagitis, Peptic / Q000517:prevention & control; D004943:Esophagogastric Junction / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D006801:Humans; D007080:Ileocecal Valve / Q000502:physiology; D007082:Ileum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome