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  • Title: New type of jejunal interposition method after gastrectomy.
    Author: Zherlov G, Koshel A, Orlova Y, Zykov D, Sokolov S, Rudaya N, Karpovitch A.
    Journal: World J Surg; 2006 Aug; 30(8):1475-80. PubMed ID: 16850144.
    Abstract:
    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.
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