Abstract
A wide range of inevitable adverse effects may emerge after total gastrectomy, mainly due to loss of reservoir organ and exclusion of the duodenal route. None of the available reconstructive methods has achieved a satisfactory functional result. A new method has been tried to overcome postgastrectomy problems. In this preliminary clinical study, a reconstruction technique involving interposition of the ileocaecal segment as a gastric substitute after pylorus-preserving near-total gastrectomy (restorative caecogastroplasty) was applied in six selected patients with proximal gastric carcinoma. Postoperative radiological and scintigraphic studies revealed adequate reservoir capacity, satisfactory neogastric emptying and a well functioning pyloric mechanism. During mean follow-up of 15 (range 3-36) months, dumping syndrome, reflux oesophagitis and weight loss were not observed. It is suggested that restorative caecogastroplasty combines the advantages of intact sphincter mechanisms and maintaining the duodenal route as well as sufficient reservoir volume. This method can be used safely as an alternative to other methods of reconstruction.
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