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Jejunal pouch with nerve preservation and interposition after total gastrectomy.
Hepatogastroenterology. 1998 Mar-Apr; 45(20):558-62.H

Abstract

BACKGROUND/AIMS

In this paper, we describe operative technique details and our results with a modified technique for jejunal pouch formation and interposition after total gastrectomy, with an overall aim to achieve results superior to jejunal pouch and Roux-en-Y reconstruction, as reported in the literature.

METHODOLOGY

Following total gastrectomy, the jejunum was divided approximately 20 cm distal to the ligament of Treitz. Marginal vessels were not divided in order to preserve the nerves in the 50 cm of distal jejunum which would be used for pouch construction. The pouch was constructed using a linear stapler (Endo GiA, United States Surgical Corp., Norwalk, Conn). A total of 15 gastric cancer patients underwent construction of a nerve-preserving jejunal pouch and interposition following total gastrectomy.

RESULTS

None of the patients experienced postoperative complications due to pouch construction. Additionally, discomforts such as dumping or stagnation were not observed. Mild reflux esophagitis occurred in five of the 15 patients and was resolved by oral administration of camostat mesilate. Six months after surgery, the average patient's diet volume and body weight had gradually increased to 79% and 86%, respectively, of the presurgical levels. A dual phase, dual isotope radionucleid pouch emptying study was also performed six months after surgery. The intra-pouch RI retention rate was 47% for liquid food and 53% for solid food 120 minutes after intake. The emptying rate was slower for both solid and liquid food, as compared with healthy individuals.

CONCLUSIONS

The pouch-emptying test demonstrated a satisfactory retention capacity and an acceptable emptying time as a gastric substitute. The patients who underwent gastric reconstruction with a nerve-preserving jejunal pouch with interposition have experienced a reasonably good quality of life.

Authors+Show Affiliations

Department of Surgery, Ojiya General Hospital, Gunma, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9638451

Citation

Kobayashi, I, et al. "Jejunal Pouch With Nerve Preservation and Interposition After Total Gastrectomy." Hepato-gastroenterology, vol. 45, no. 20, 1998, pp. 558-62.
Kobayashi I, Ohwada S, Ohya T, et al. Jejunal pouch with nerve preservation and interposition after total gastrectomy. Hepatogastroenterology. 1998;45(20):558-62.
Kobayashi, I., Ohwada, S., Ohya, T., Yokomori, T., Iesato, H., & Morishita, Y. (1998). Jejunal pouch with nerve preservation and interposition after total gastrectomy. Hepato-gastroenterology, 45(20), 558-62.
Kobayashi I, et al. Jejunal Pouch With Nerve Preservation and Interposition After Total Gastrectomy. Hepatogastroenterology. 1998 Mar-Apr;45(20):558-62. PubMed PMID: 9638451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Jejunal pouch with nerve preservation and interposition after total gastrectomy. AU - Kobayashi,I, AU - Ohwada,S, AU - Ohya,T, AU - Yokomori,T, AU - Iesato,H, AU - Morishita,Y, PY - 1998/6/25/pubmed PY - 1998/6/25/medline PY - 1998/6/25/entrez SP - 558 EP - 62 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 45 IS - 20 N2 - BACKGROUND/AIMS: In this paper, we describe operative technique details and our results with a modified technique for jejunal pouch formation and interposition after total gastrectomy, with an overall aim to achieve results superior to jejunal pouch and Roux-en-Y reconstruction, as reported in the literature. METHODOLOGY: Following total gastrectomy, the jejunum was divided approximately 20 cm distal to the ligament of Treitz. Marginal vessels were not divided in order to preserve the nerves in the 50 cm of distal jejunum which would be used for pouch construction. The pouch was constructed using a linear stapler (Endo GiA, United States Surgical Corp., Norwalk, Conn). A total of 15 gastric cancer patients underwent construction of a nerve-preserving jejunal pouch and interposition following total gastrectomy. RESULTS: None of the patients experienced postoperative complications due to pouch construction. Additionally, discomforts such as dumping or stagnation were not observed. Mild reflux esophagitis occurred in five of the 15 patients and was resolved by oral administration of camostat mesilate. Six months after surgery, the average patient's diet volume and body weight had gradually increased to 79% and 86%, respectively, of the presurgical levels. A dual phase, dual isotope radionucleid pouch emptying study was also performed six months after surgery. The intra-pouch RI retention rate was 47% for liquid food and 53% for solid food 120 minutes after intake. The emptying rate was slower for both solid and liquid food, as compared with healthy individuals. CONCLUSIONS: The pouch-emptying test demonstrated a satisfactory retention capacity and an acceptable emptying time as a gastric substitute. The patients who underwent gastric reconstruction with a nerve-preserving jejunal pouch with interposition have experienced a reasonably good quality of life. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/9638451/Jejunal_pouch_with_nerve_preservation_and_interposition_after_total_gastrectomy_ L2 - https://medlineplus.gov/stomachcancer.html DB - PRIME DP - Unbound Medicine ER -