Roux-en-Y Reconstruction with Stapled Distal Jejunal Pouch after Total Gastrectomy

Roux-en-Y reconstruction after total gastrectomy is a simple and safe procedure; however, it eliminates the gastric reservoir function and markedly changes the postoperative digestive physiology. The patients therefore suffer from insufficient food intake and malabsorption. It has been reported that...

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Bibliographic Details
Published in:The American surgeon 2010-05, Vol.76 (5), p.526-528
Main Authors: ISHIGAMI, Sumiya, ARIDOME, Kuniaki, AIKOU, Takashi, NATSUGOE, Shoji, NAKAJO, Akihiro, MATSUMOTO, Masataka, UCHIKADO, Yasuto, SETOYAMA, Tetsuro, ARIGAMI, Takaaki, ARIMA, Hideo, UENO, Shinichi, KIJIMA, Yuko
Format: Article
Language:English
Subjects:
Anastomosis, Roux-en-Y - methods
Biological and medical sciences
Body mass index
Clinical trials
Cohort Studies
Esophagus - surgery
Feasibility Studies
Female
Gastrectomy
General aspects
Humans
Jejunum - surgery
Male
Medical sciences
Middle Aged
Retrospective Studies
Sample size
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Surgical Stapling
Surgically-Created Structures
Treatment Outcome
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Description
Summary:Roux-en-Y reconstruction after total gastrectomy is a simple and safe procedure; however, it eliminates the gastric reservoir function and markedly changes the postoperative digestive physiology. The patients therefore suffer from insufficient food intake and malabsorption. It has been reported that jejunal pouch reconstruction increases food intake and improves the nutritional status. We established a novel Roux-en-Y reconstruction with stapled distal jejunal pouch after total gastrectomy. A jejunal pouch, 8 cm in size, was attached at the jejunojejunostomy. We performed this novel reconstruction for 20 gastric cancer patients after total gastrectomy with lymph node dissection as a feasible study. One year after operation, the average percentage weight was maintained in more than 90 per cent and 17 (85%) of these patients were in the normal range of the body mass index. This procedure may improve postoperative malnutrition after total gastrectomy according to our feasible study. A multicenter randomized trial of this approach comparing with Roux-en-Y reconstruction without a pouch is ongoing.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481007600523