Operations to Resect, Replace, or Bypass the Esophagus
- 248 Downloads
A number of surgeons have asserted that resection of the lower esophagus and proximal stomach for lesions near the gastric cardia, followed by esophagogastric anastomosis, is an operation with a high mortality rate and a high incidence of reflux esophagitis. Moreover, some say this operation is no better from the nutritional point of view than total gastrectomy with esophagojejunostomy. Our experience is completely to the contrary. After total gastrectomy, dumping is common and nutritional rehabilitation is often difficult. On the other hand, we have observed that very few patients experience serious symptoms of reflux esophagitis following esophagogastrectomy with an end-to-side anastomosis. No dietary restrictions have been necessary. In 44 consecutive cases, among patients whose average age was over 70, we encountered (and reported) no clinical anastomotic leaks and no deaths.
KeywordsTotal Gastrectomy Reflux Esophagitis Gastric Cardia Cervical Esophagus Jejunal Interposition
Unable to display preview. Download preview PDF.
- Belsey R (1965) Reconstruction of the esophagus with left colon. J Thorac Cardio- vasc Surg 49: 33Google Scholar
- Merendino KA, Dillard DH (1955) The concept of sphincter substitution by an interposed jejunal segment for anatomic and physiologic abnormalities at the esophagogastric junction with special reference to reflux esophagitis, cardiospasm and esophageal varices. Ann Surg 142: 486PubMedCrossRefGoogle Scholar