RESTORATIVE CAECOGASTROPLASTY RECONSTRUCTION AFTER PYLORUS-PRESERVINGNEAR-TOTAL GASTRECTOMY - A PRELIMINARY-STUDY

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.