Comparative Analysis of Two Types of Gastric Replacement After Total Gastrectomy

Kummer, D.; Kieninger, G.; Anger, Klaus; Maier, Harald

doi:10.1007/978-3-642-67368-9_43

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…This would include the interposition of a colon segment. It has been suggested that an antiperistaltic segment can be used [5] as a means of slowing the progression of ingested food.…”

Section: Methods Of Total Gastric Reconstructionmentioning

confidence: 99%

Surgical procedures for gastric substitution

1987

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The most serious of the problems that arise after total gastrectomy and reconstruction of a continuous gastrointestinal tract by means of a simple esophagojejunostomy can be ascribed to the lack of primary reservoir formation and to alkaline reflux esophagitis. These difficulties can be overcome by means of pouch formation, low insertion of the bile duct, and jejunal plication. Personal follow-up examinations in patients (over I year after gastric substitution) have yielded both subjective and objective findings that are almost identical with those recorded in a subject with intact stomach. The one striking finding to emerge remains an elevated fat excretion.

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“…This would include the interposition of a colon segment. It has been suggested that an antiperistaltic segment can be used [5] as a means of slowing the progression of ingested food.…”

Section: Methods Of Total Gastric Reconstructionmentioning

confidence: 99%

Surgical procedures for gastric substitution

1987

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“…Furthermore, Bradley and co-workers [13] found no difference between patients with or without a gastric substitute when recording the amount of food ingested and weight development after the operation. On the other hand, Kummer and co-workers [41] found a tendency toward better weight development in patients with reservoir function of the gastric substitute than those without. In the study by Lygidakis [47], an extensive experience with a new pouch reconstruction, 30 of 32 patients experienced a slight weight gain.…”

Section: Weight Gainmentioning

confidence: 97%

“…Otherwise, no data are available to support the concept that a gastric substitute would consistently reduce postprandial complaints and subsequently increase the feeling of well being after a total gastrectomy. There are some indications, however, that patients who receive gastric replacements return to work and a normal social life more frequently than those obtaining a reconstruction without a gastric substitute [40,41].…”

Section: The Effect Of Gastric Replacement On Various Intestinal Func...mentioning

confidence: 99%

Intestinal function after total gastrectomy and possible consequences of gastric replacement

Olbe

Lundell

1987

World j. surg.

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About half of the patients subjected to total gastrectomy experience weight loss. Malabsorption, particularly fat malabsorption, is a common feature after total gastrectomy. This may be due to shortened intestinal transit time and small bowel bacterial overgrowth, but is less often due to diarrhea or pancreatic exocrine insufficiency. Malabsorption is not closely related to weight loss, which is mainly caused by recurrent malignant diseases and a low postoperative calorie intake. The low calorie intake persists in half of the patients despite supervision of the patients by clinical nutritionists at the outpatient clinic. Roux-en-Y reconstruction of the esophago-intestinal canal has minimized the problem of postoperative reflux esophagitis. Severe postprandial symptoms are uncommon although epigastric oppression and fullness is an obligatory feature in the immediate postoperative period but successively vanishes in half of the patients.Gastric replacement by various enteric reservoirs has been used to improve nutrition after total gastrectomy. The effect of gastric replacement is, however, uncertain since no prospective, randomized studies are available. A gastric substitute seems to have only a marginal effect on meal size, daily caloric intake, and weight gain. A reservoir function of gastric substitutes has been documented but the effect on intestinal transit time is unknown. Stagnation of intestinal contents in a gastric replacement is common, but its significance for bacterial overgrowth, malabsorption, and clinical outcome remains to be determined.

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Comparative Analysis of Two Types of Gastric Replacement After Total Gastrectomy

Cited by 2 publications

References 3 publications

Surgical procedures for gastric substitution

Surgical procedures for gastric substitution

Intestinal function after total gastrectomy and possible consequences of gastric replacement

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