title: A long-term follow-up result of pouch plasty for severe dysfunction of jejunal pouch reconstruction after total gastrectomy: a case report.
abstract: A 78-year-old woman with malignant lymphoma of the stomach underwent total gastrectomy with a jejunal-pouch (J-pouch) reconstruction in 1994. Twelve years after surgery the patient began to suffer epigastric distress and reflux symptoms. Eventually, she was unable to take anything by mouth. A series of diagnostic images seemed to indicate that the main cause of the dysfunction was flaccidity of the J-pouch and deformity of the outflow route induced by chronic excessive dilatation of the pouch wall. Because all conservative managements only led to temporary improvement and ended in failure, she hoped to receive the operation. We designed "pouch plasty" capable of ameliorating the pouch dysfunction. The aim of pouch plasty was to improve uneven tension of the pouch wall and repair deformity of the outflow route of the food. After the operation, the J-pouch resumed adequate drainage and had good reservoir function. More than 7 years later, the patient had no further complications.
authors.affiliation: Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inagawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Terashima
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Akashi
authors.forename: Katsuji
authors.initials: K
authors.lastname: Hisakura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Enomoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
mesh_terms: D000368:Aged; D039021:Colonic Pouches / Q000473:pathology*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008223:Lymphoma / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Delayed emptying; Gastrectomy; Jejunal pouch reconstruction; Pouch plasty