[Reconstruction modes following gastrectomy. Results of experimental and clinical controlled trials].
Reconstruction modes following gastrectomy. Results of experimental and clinical controlled trials. In animal experiments four reconstruction methods following gastrectomy were compared: Roux-en Y reconstruction with (n = 33) and without pouch (n = 50) and isoperistaltic jejunum interposition with (n = 26) and without pouch (n = 55). The results were mostly influenced by the extent of esophagitis, documenting the reflux reduction by a pouch. Weight gain was slightly higher following jejunum interposition.Roux-en Y pouch reconstruction with jejunum interposition with pouch was compared in a randomized controlled trial. The additional operative effort of jejunum interposition did not achieve benefits in outcome. Therefore, Roux-en Y reconstruction should be advocated as standard reconstruction. The second randomized controlled trial compared Roux-en Y reconstruction with and without pouch. After more than three years, there was an advantage in life quality for patients with pouch indicating that patients with a favorable prognosis following gastrectomy should be reconstructed with a pouch.
Fein
M
M
Chirurgische Universitätsklinik Würzburg, Germany. fein@chirurgie.uni-wuerzberg.de
Fuchs
K H
KH
Beese
G
G
Freys
S M
SM
Thiede
A
A
D000713:Anastomosis, Roux-en-Y; D000818:Animals; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D051381:Rats; D011917:Rats, Inbred Lew; D019651:Plastic Surgery Procedures; D013274:Stomach Neoplasms / Q000601:surgery*