RECONSTRUCTION AFTER TOTAL GASTRECTOMY BY THE INTERPOSITION OF A DOUBLE JEJUNAL POUCH USING A DOUBLE STAPLING TECHNIQUE

Background After total gastrectomy, sustaining good nutrition is extre mely important for maintaining quality of life. A technique of neogast ric pouch formation based on current physiological reconstructive prin ciples is presented. Methods The use of a modified interpositioned dou ble jejunal pouch following total gastrectomy in 18 patients with canc er was reviewed. This technique results in a complete pouch and uses a double stapling technique with site-specific anastomosis between the oesophagus and pouch, in which a Hisoid angle is created. Results Ther e were no anastomotic leaks and pouch blood flow was within normal exp ected limits. Mean oesophageal pH above 7.0 for one 24-h period was 7. 7 per cent. Emptying half-time was 67.8 min. After 2 years mean body-w eight was 98.3 per cent of expected, mean food volume was 94.0 per cen t of expected and mean meal frequency was 3.0 per day. Conclusion This form of gastric reconstruction is an acceptable procedure which impro ves the quality of life in patients undergoing total gastrectomy.