FUNCTIONAL RESULTS AFTER TOTAL GASTRECTOMY WITH ENTERIC POUCH RECONSTRUCTION A REVIEW OF 34 CASES

34 patients with gastric carcinoma, treated by total gastrectomy,had a reconstruction procedure, consisting of a pouch as proposed by Lygida kis or as a variant of the procedure:the beta-modification. In 31 pati ents a total gastrectomy was performed for histologically proven gastr ic adenocarcinoma. Two patients presented with a gastric lymphoma and one with a gastric leiomyosarcoma. Operative mortality was 8.8%. Two p atients (5.8%) developed leakage of the oesophago-enteral anastomosis and subsequently died from sepsis, while a third patient died from a p ostoperative pneumonia. Early complications occurred in 4 patients and consisted of dysphagia, due to stenosis of the oesophago-enteric anas tomosis. All 4 patients (12.9%) were treated with endoscopic dilatatio n and were cured of their dysphagia. One patient developed a late pept ic ulcer at the pouch anastomosis and needed a reintervention. Nine pa tients died from extension of their primary disease within the first p ostoperative year. The 22 surviving patients are all without symptoms and regained their pre-illness weight. In conclusion, the proposed tec hnique of pouch reconstruction has an acceptable operative mortality a nd morbidity comparable to or even better than in previously described methods. The long term functional results are better and more patient s gain weight.