C. Uras et al., RESTORATIVE CAECOGASTROPLASTY RECONSTRUCTION AFTER PYLORUS-PRESERVINGNEAR-TOTAL GASTRECTOMY - A PRELIMINARY-STUDY, British Journal of Surgery, 84(3), 1997, pp. 406-409
Background A wide range of inevitable adverse effects may emerge after
total gastrectomy, mainly due to loss of reservoir organ and exclusio
n of the duodenal route. None of the available reconstructive methods
has achieved a satisfactory functional result. A new method has been t
ried to overcome postgastrectomy problems. Methods In this preliminary
clinical study, a reconstruction technique involving interposition of
the ileocaecal segment as a gastric substitute after pylorus-preservi
ng near-total gastrectomy (restorative caecogastroplasty) was applied
in six selected patients with proximal gastric carcinoma. Results Post
operative radiological and scintigraphic studies revealed adequate res
ervoir capacity, satisfactory neogastric emptying and a well functioni
ng pyloric mechanism. During mean follow-up of 15 (range 3-36) months,
dumping syndrome, reflux oesophagitis and weight loss were not observ
ed. Conclusion It is suggested that restorative caecogastroplasty comb
ines the advantages of intact sphincter mechanisms and maintaining the
duodenal route as well as sufficient reservoir volume. This method ca
n be used safely as an alternative to other methods of reconstruction.