Functional results of different reconstructive procedures after total gastrectomy

Huguier, M; Lancret, J M; P, Bernard; C, Baschet; Henand, F. Le

doi:10.1002/bjs.1800630909

Cited by 48 publications

(15 citation statements)

References 2 publications

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“…The results of Rouxen-Y anastomosis were also good because even though the highest percentage of symptoms occurred as a result of this technique, the difference between this and the other 2 groups was not statistically significant. We concur with Huguier et al [ 15] that there is no great difference in the long-term results of these 2 techniques. The technique of (3-anastomosis reconstruction we adopted caused a signif icantly higher frequency of alkaline reflux oesophagitis than the other 2 techniques.…”

Section: Resultssupporting

confidence: 74%

Symptomatic and Objective Assessment after Total Gastrectomy: A Comparison of Three Methods of Reconstruction of the Digestive Tract

et al. 1992

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No method for reconstructing the digestive tract following total gastrectomy is considered ideal. We made a retrospective, symptomatic and objective assessment of 49 patients who had undergone a curative total gastrectomy in the period 1974-1989 to evaluate the long-term results of the three methods we had used. Fourteen patients (28.5%) had had jejunal pouch interposition, 20 patients (41 %) Nakayama’s β-anastomosis and 15 patients (30.5%) Roux-en-Y reconstruction. The frequency of symptoms, oesophagitis at the endoscopic examination, and nutritional status (body weight vs. ideal weight, haemoglobin and serum albumin values) were evaluated in each of the three groups. The mean follow-up was 38 months (range: 6-124 months). No statistically significant differences were seen among the three groups as far as nutritional status and frequency of symptoms were concerned; however, endoscopic findings showed that alkaline reflux oesophagitis was associated with β-anastomosis reconstruction (35% vs. 7% after jejunal pouch interposition, and 6.5% after Roux-en-Y reconstruction; partitioning χ²: p = 0.012). Our findings show that the long-term results after total gastrectomy of digestive reconstruction with jejunal pouch interposition and the Roux-en-Y procedure were not significantly different.

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Section: Resultssupporting

confidence: 74%

Symptomatic and Objective Assessment after Total Gastrectomy: A Comparison of Three Methods of Reconstruction of the Digestive Tract

et al. 1992

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“…The duodenal passage has been held to be more physiologic (26,27), but no beneficial effects of the duodenal passage by jejunal interposition with a pouch compared with the less demanding Roux-en-Y reconstruction was found in a large controlled study with a long clinical follow-up (18). Duodenal passage is probably of no major clinical importance.…”

Section: Discussionmentioning

confidence: 91%

Long-Term Follow-up of Patients with Jejunal Pouch Reconstruction after Total Gastrectomy: A Randomized Prospective Study

Iivonen

Mattila²,

Nordback³

et al. 2000

Scandinavian Journal of Gastroenterology

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Iivonen MK, Mattila JJ, Nordback IH, Matikainen MJ. Long-term follow-up of patients with jejunal pouch reconstruction after total gastrectomy. A randomized prospective study. Scand J Gastroenterol 2000;35:679-685. Background: Fifty-one patients were operated on during 1988-1992 and randomized after total gastrectomy to one of two reconstruction types. Twenty patients with jejunal pouch reconstruction and 14 patients with Roux-en-Y reconstruction (67% of all) survived at least 3 years after total gastrectomy. We studied symptoms, eating capacity, and nutrition in these patients during the clinical follow-up; 21 patients were assessed by mail questionnaire 8 years after total gastrectomy. Methods: Postoperative symptoms, number of meals, and eating capacity were assessed by standard questionnaire during 3 years' follow-up. Weight loss and nutritional laboratory variables were measured, and upper intestinal endoscopy with biopsy was performed during the follow-up. Eight years after the operation symptoms, ability to eat, and number of meals consumed were studied by means of a mail questionnaire. Results: Three years postoperatively dumping (64% compared with 10%, P`0.05) and early satiety (86% compared with 5%, P`0.05) were commoner in the Roux-en-Y group. In the pouch group eating capacity was better (96% of normal compared with 67%, P`0.05), and the patients ate fewer meals per day (mean, 2.7 versus 5.3, P`0.05) at 3 years. Mean weight loss at 3 years was 9.9 kg in the Roux-en-Y group compared with 1.5 kg in the pouch group (P`0.05). 25 (OH) vitamin D concentration tended to be higher in the pouch group (47.3 nmol/l compared with 33.9 nmol/l). In the Roux-en-Y group serum alkaline phosphatase activity increased significantly during the 3 postoperative years (from mean163 U/l to 248 U/l, P`0.01) and tended to be higher (248 U/l compared with 216 U/l in the pouch group). None of the patients developed oesophagitis or pouchitis during the follow-up. One patient developed a bezoar in the pouch 5 years after gastrectomy. Conclusions: Pouch reconstruction after total gastrectomy is associated with diminished postoperative symptoms, better eating capacity, and decreased weight loss compared with Roux-en-Y reconstruction. Jejunal pouch reconstruction is thus the recommended surgical method after total gastrectomy.

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“…However, a technique described by Rosanov in 1958 does the reconstruction in Roux-en-Y with jejuno-duodenal anastomosis latero-terminal 4 . The references in the literature on this technique are not numerous 6,15,18 . The aim of this paper is to describe a modified technique of Rosanov after total gastrectomy, combined with the objective of minimizing the intestinal malabsorption after this procedure.…”

Section: Introductionmentioning

confidence: 99%

Técnica de Rosanov modificada na reconstrução do trato digestivo após gastrectomia total

Lopes¹,

Cesconetto²,

Coelho-Neto³

et al. 2011

ABCD, arq. bras. cir. dig.

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-Background -Total gastrectomy in gastric cancer is a procedure not without early and late complications and type of reconstruction of the digestive tract to be used is still a controversial issue in literature. Aim -To describe a modified Rosanov technique after total gastrectomy, employed with the aim of minimizing the intestinal malabsorption and other complications following this procedure. Method -Technical modification is not to hold distal ligature on jejuno-duodenal anastomosis, thereby offering to the food transit two routes by the duodenum and by the jejunum. Results -There were no complications and the initial series showed a benefit in the nutritional aspects after six months of postoperative follow-up. Conclusion -It is a simple technique and preliminary results with its use were very satisfactory, although other clinical studies must be conducted to demonstrate the advantages of the technique in the long term. ABCDDV/786RESUMO -Racional -A gastrectomia total nas neoplasias gástricas é um procedimento não isento de complicações precoces e tardias e o tipo de reconstrução do trato digestivo a ser utilizado é ainda questão controversa na literatura. Objetivo -Descrever a técnica de Rosanov modificada, após a gastrectomia total, empregada com o objetivo de minimizar a má absorção intestinal e outras complicações após este tipo de procedimento. Métodos -A modificação técnica consiste de não realizar a ligadura distal à anastomose jejuno-duodenal, fazendo assim com que o trânsito alimentar tenha duas vias de passagens, pelo duodeno e pelo jejuno. Resultados -Não foram registradas complicações e a casuística inicial mostrou vantagens sob os aspectos nutricionais após seis meses de seguimento pós-operatório. Conclusão -É técnica de fácil execução e os resultados preliminares com o seu emprego foram muito satisfatórios, no entanto outros estudos clínicos devem ser realizados para demonstrar as vantagens da técnica a longo prazo.

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Functional results of different reconstructive procedures after total gastrectomy

Cited by 48 publications

References 2 publications

Symptomatic and Objective Assessment after Total Gastrectomy: A Comparison of Three Methods of Reconstruction of the Digestive Tract

Symptomatic and Objective Assessment after Total Gastrectomy: A Comparison of Three Methods of Reconstruction of the Digestive Tract

Long-Term Follow-up of Patients with Jejunal Pouch Reconstruction after Total Gastrectomy: A Randomized Prospective Study

Técnica de Rosanov modificada na reconstrução do trato digestivo após gastrectomia total

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