ILEOCECAL INTERPOSITIONAL GRAFT AS GASTRIC REPLACEMENT AFTER TOTAL GASTRECTOMY AND DISTAL ESOPHAGECTOMY

The ileocecal interpositional graft is an alternative method for repla cing the distal esophagus and the stomach. A pedunculated ileocecal in terpositional graft rotated 180 degrees clockwise and placed across th e hiatus between the proximal esophagus and the duodenum could act as a reservoir and protect against reflux (ileocecal valve) while preserv ing the duodenal passage. Two patients underwent this operation (the f irst patient has been observed for 12 postoperative months). We also u sed this technique to replace the stomach alone below the diaphragm, a technique that had been abandoned in the surgical literature since 19 52, although the concept and initial experiences were already promisin g at that time. In favor of these attractive features of the ileocecal interpositional graft as gastric replacement, we have begun a control led examination of this method.