P3–054 - Reconstruction After Total Gastrectomy in Patients with Gastric Cancer: Our Hospital Experience

Abstract

Background and aims: Gastric cancer (GC) remains one of most worldwide frequent cancers. After total gastrectomy it is necessary to realize reconstructin of the upper part digestive tract. The double tract (DT) method is the optimal reconstruction procedure after total gastrectomy for patients with gastric cancer.Methods: In General hospital Sveti Vraceviin Bijeljina from January 2006 to January 2012, 67 patients who underwent a total gastrectomy with a curative resection. In all patients to the esophagojejunostomy, the side-to-end jejunoduodenostomy was performed manually, 35 cm distal to the esophagojejunal anastomosis. The end of the Y limb was anastomosed manually to the side of the Roux limb, approximately 15 cm distal to the jejunoduodenal anastomosis. It is prospectively study for all patients and included their history, clinicopathologic examinations, postoperative clinical information, and complications.Results: In these study were observed early postoperative complications and mortality, postoperative food intake and nutritional status (hemoglobin, total proteins and albumin), and incidence of diarrhea and dumping syndrome at 1 and 5 years. The overall 1-, 3-, and 5-year cumulative survival rate were 53.3%, 24.6%, and 10.8%, respectively. Concerning tumor location, tumor diffused in thee sections of stomach in 67 cases, mainly in cardia and body in 20 cases, mainly in body and antrum in 36 cases, and only in body of stomach in 11 cases. In the pathological examination, the tumors of 57 patients were diagnosed as adenocarcinoma, 7 as malignant lymphoma, and 3 as leiomyosarcoma.Conclusions: The benefits of this method are (1) a simple procedure; (2) preservation of the duodenal passage; (3) no duodenal stump, resulting in no risk of postoperative stump rupture. Background and aims: Gastric cancer (GC) remains one of most worldwide frequent cancers. After total gastrectomy it is necessary to realize reconstructin of the upper part digestive tract. The double tract (DT) method is the optimal reconstruction procedure after total gastrectomy for patients with gastric cancer. Methods: In General hospital Sveti Vraceviin Bijeljina from January 2006 to January 2012, 67 patients who underwent a total gastrectomy with a curative resection. In all patients to the esophagojejunostomy, the side-to-end jejunoduodenostomy was performed manually, 35 cm distal to the esophagojejunal anastomosis. The end of the Y limb was anastomosed manually to the side of the Roux limb, approximately 15 cm distal to the jejunoduodenal anastomosis. It is prospectively study for all patients and included their history, clinicopathologic examinations, postoperative clinical information, and complications. Results: In these study were observed early postoperative complications and mortality, postoperative food intake and nutritional status (hemoglobin, total proteins and albumin), and incidence of diarrhea and dumping syndrome at 1 and 5 years. The overall 1-, 3-, and 5-year cumulative survival rate were 53.3%, 24.6%, and 10.8%, respectively. Concerning tumor location, tumor diffused in thee sections of stomach in 67 cases, mainly in cardia and body in 20 cases, mainly in body and antrum in 36 cases, and only in body of stomach in 11 cases. In the pathological examination, the tumors of 57 patients were diagnosed as adenocarcinoma, 7 as malignant lymphoma, and 3 as leiomyosarcoma. Conclusions: The benefits of this method are (1) a simple procedure; (2) preservation of the duodenal passage; (3) no duodenal stump, resulting in no risk of postoperative stump rupture.