New type of jejunal interposition method after gastrectomy. 2006

Georgy Zherlov, and Andrey Koshel, and Yuliya Orlova, and Dmitry Zykov, and Sergey Sokolov, and Nataliya Rudaya, and Alexander Karpovitch
Department of Surgery, Scientific Research Institute of Gastroenterology, Seversk, Tomsk Region, Russia.

BACKGROUND Total and subtotal gastrectomies are methods of choice in surgical treatment of gastric cancer. These ablative operations eliminate the gastric reservoir and severely alter digestive physiology. METHODS We have created a unique method of reconstruction of "the jejunal pouch" following gastrectomy using the first loop of the jejunum together with the formation of antireflux anastomosis. RESULTS An analysis of the results of the application of a new way of reconstruction of the digestive path was carried out. Seventy-five patients with gastric cancer received the new type of reconstruction. Among them, there were 52 men and 23 women aged 36-72 years. In the new interposition method group, in the first year after the surgical operation, the patients returned to 89.8% of their original body weight and in the second year to 89.7%; and in the Roux-en-Y group the patients returned to 64.4% and 59.2% of their body weight respectively. Further body weight fluctuations in patients after the new operative technique were determined by diet and aging and were not connected with digestive disorders. In the group receiving the new operative technique, the dumping syndrome was recorded in 4 (5.3%) patients and in the Roux-en-Y operation this syndrome occurred in 22 (27.5%) patients more than 1 year following the operations. There were no cases of reflux disease in the group undergoing the new operative technique. The average evacuation time of the "jejunal pouch" was 84+/-9.8 min after the new operation and 57.5+/-10.1 minutes after the Roux-en-Y operation. CONCLUSIONS The comparative analysis of the results of the new operation (75 patients) with 80 patients (who were operated on using the traditional method) after the Roux-en-Y operation showed the significant advantages of the new method due to a diminished occurrence of troublesome gastrointestinal symptoms. We consider that the reconstruction of the gastrointestinal tract after total gastrectomy should give the maximal comfort for the rest of the patient's life.

UI MeSH Term Description Entries
D007583 Jejunum The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum. Jejunums
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D005260 Female Females
D005743 Gastrectomy Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed) Gastrectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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