Kontinuierliche Fett- und Glucoseresorptionsbestimmungen bei verschiedenen Anastomosierungsformen nach Gastrektomie beim Menschen

Schrader, C. P.; Rebholz, E.; Koslowski, L; Konold, P.; Kieninger, G.; Otten, Gillis R.; Müller, Carsten

doi:10.1007/978-3-662-01079-2_54

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“…In comparison with gastrectomized patients treated by end-to-side esophagojejunostomy and esophagoduodenostomy, fat absorption was 3 times greater. Patients treated with the Longmire interposition also showed a fat absorption rate far below that of the patients treated by our new technique, but the results were slightly better than those in the other 2 groups [24]. The increased fat absorption correlated with the postoperative weight gain of patients not suffering from cancer recurrence.…”

Section: Clinical Resultsmentioning

confidence: 53%

Clinical experience with a new method of gastric replacement following total gastrectomy

et al. 1979

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Since 1972 we have used a new type of gastric replacement following total gastrectomy that was developed experimen. tally in our laboratory. The reconstruction is done by endto-end interposition between the esophagus and duodenum of a proximal 25 cm isoperistaltic jejunal segment and a distal 10 cm antiperistaltic (reversed) jejunal segment. The reversed segment acts as a substitute for the pylorus, causing delayed and intermittent emptying of the above proximal isoperistaltic segment. To date we have performed this operation in 31 patients, with only 1 postoperative death and nonfatal anastomotic leakage at the esophagojejunal junction in 4 patients. The longest postoperative observation period has been more than 4 years. The function of the gastric substitute has been found to be very satisfactory by cineradiography, endoscopy, and fat absorption tests. Based on our encouraging experimental and clinical experi. ence, it is concluded that this new method of gastric replacement has many advantages over other methods. The quality of life of patients treated in this way has been better, since digestion and absorption have been improved and many of the typical postgastrectomy sequelae have been reduced or eliminated. This type of reconstruction is now being used routinely in our clinic in curative resections for gastric cancer.

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Section: Clinical Resultsmentioning

confidence: 53%