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Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results.
Hepatogastroenterology. 1997 Mar-Apr; 44(14):588-98.H

Abstract

BACKGROUND/AIMS

Either straight Roux-en-Y anastomosis or jejunal interposition used to be adopted following total gastrectomy. However, dissatisfaction with regard to postoperative quality of life has prompted the development of new techniques. The purpose of this study is to describe and assess the authors' technical devices in jejunal pouch (J-pouch) reconstruction following total gastrectomy and the results of these operations.

PATIENTS AND METHODS

A prospective study of 17 patients with malignant gastric disease (nine with J-pouch interposition, eight with J-pouch Roux-en-Y reconstruction) was performed. To facilitate the side-to-side anastomosis of the jejunal loop, the authors used an autosuture instrument. The anastomosis was then checked for hemostasis using a vaginoscope.

RESULTS

An Endo GIA with a 60-mm long white cartridge (closed height of staples, 1.0 mm) is the instrument of choice to create the J-pouch. This autosuture instrument fires triple staggered staple lines, which minimizes bleeding from the anastomosed site and reduces operative time. No anastomotic leaks were associated with the autosuture instrument. The vaginoscope facilitates a direct observation of the staple lines internally and if necessary, enables secure hemostasis with sutures. Bowel motility was satisfactory for both surgical procedures, as measured by the percentage of radiopaque markers which were expelled from the pouch. There were no serious complications, and all patients have currently survived, a maximum of 5 years and 6 months after surgery, except for one patient who died from recurrent disease.

CONCLUSION

The authors' procedures for J-pouch reconstruction are advantageous due to a favorable postoperative quality of life, with low complication rates.

Authors+Show Affiliations

Department of Surgery I, Tokyo Medical and Dental University, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9164542

Citation

Takeshita, K, et al. "Technical Devices in Jejunal Pouch Reconstruction Following Total Gastrectomy, Including Postoperative Results." Hepato-gastroenterology, vol. 44, no. 14, 1997, pp. 588-98.
Takeshita K, Saito N, Habu H, et al. Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results. Hepatogastroenterology. 1997;44(14):588-98.
Takeshita, K., Saito, N., Habu, H., Saeki, I., Honda, T., Tani, M., Kando, F., & Endo, M. (1997). Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results. Hepato-gastroenterology, 44(14), 588-98.
Takeshita K, et al. Technical Devices in Jejunal Pouch Reconstruction Following Total Gastrectomy, Including Postoperative Results. Hepatogastroenterology. 1997 Mar-Apr;44(14):588-98. PubMed PMID: 9164542.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results. AU - Takeshita,K, AU - Saito,N, AU - Habu,H, AU - Saeki,I, AU - Honda,T, AU - Tani,M, AU - Kando,F, AU - Endo,M, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 588 EP - 98 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 44 IS - 14 N2 - BACKGROUND/AIMS: Either straight Roux-en-Y anastomosis or jejunal interposition used to be adopted following total gastrectomy. However, dissatisfaction with regard to postoperative quality of life has prompted the development of new techniques. The purpose of this study is to describe and assess the authors' technical devices in jejunal pouch (J-pouch) reconstruction following total gastrectomy and the results of these operations. PATIENTS AND METHODS: A prospective study of 17 patients with malignant gastric disease (nine with J-pouch interposition, eight with J-pouch Roux-en-Y reconstruction) was performed. To facilitate the side-to-side anastomosis of the jejunal loop, the authors used an autosuture instrument. The anastomosis was then checked for hemostasis using a vaginoscope. RESULTS: An Endo GIA with a 60-mm long white cartridge (closed height of staples, 1.0 mm) is the instrument of choice to create the J-pouch. This autosuture instrument fires triple staggered staple lines, which minimizes bleeding from the anastomosed site and reduces operative time. No anastomotic leaks were associated with the autosuture instrument. The vaginoscope facilitates a direct observation of the staple lines internally and if necessary, enables secure hemostasis with sutures. Bowel motility was satisfactory for both surgical procedures, as measured by the percentage of radiopaque markers which were expelled from the pouch. There were no serious complications, and all patients have currently survived, a maximum of 5 years and 6 months after surgery, except for one patient who died from recurrent disease. CONCLUSION: The authors' procedures for J-pouch reconstruction are advantageous due to a favorable postoperative quality of life, with low complication rates. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/9164542/Technical_devices_in_jejunal_pouch_reconstruction_following_total_gastrectomy_including_postoperative_results_ DB - PRIME DP - Unbound Medicine ER -