Reconstructive Procedures for Total or Proximal Gastrectomy and Postoperative Reflux

  • N. Maekawa
  • K. Sakai
  • M. Higashino
  • H. Osugi
Conference paper

Abstract

A total of 325 patients with gastric cancer were subjected to total gastrectomy and proximal gastrectomy at our clinic during the 20-years period from 1965 to 1984. The incidence of postoperative esophagitis was as high as 24% in the 106 cases treated during the first 9 years. In 1974, therefore, we started to employ the following reconstructive procedures for the prevention of this complication: (1) procedures following total gastrectomy: (a) Roux-en Y, in which a distance of 40 cm was taken between anastomoses (esophagus-jejunojejunostomy) and (b) jejunal interposition between the esophagus and duodenum, in which a jejunal segment 40 cm long was used; and (2) procedure following proximal gastrectomy: jejunal interposition between the esophagus and stomach, in which a jejunal segment of appropriate length was used so that the distance between anastomoses came to 40 cm. As a consequence, the incidence of postoperative endoscopic esophagitis was reduced to 3.7%. However, 13% of the patients who received total gastrectomy and 18% of those who received proximal gastrectomy still complained of reflux symptoms. These incidences were higher than that determined after subtotal gastrectomy.

Keywords

Catheter Washout Esophagitis Cura 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Butterfield DG, Struthers JE, Showalter JP (1972) A test of gastroesophageal sphincter competence. The common cavity test. Am J Dig Dis 17:415–421PubMedCrossRefGoogle Scholar
  2. 2.
    Bernstein LM, Baker LA (1958) A clinical test for esophagitis. Gastroenterology 34:760–781PubMedGoogle Scholar
  3. 3.
    Booth DJ, Kemmerer WT, Skinner DB (1968) Acid clearing for the distal esophagus. Arch Surg 96:731–734PubMedCrossRefGoogle Scholar
  4. 4.
    Hendrix TR, Yardley JH (1976) Consequences of gastroesophageal reflux. Clin Gastroenterol 5:955–974Google Scholar
  5. 5.
    Makuuchi H, Kumagai Y, Yamasaki E, Kakegawa T, Katagiri M, Arimori M (1979) Diagnosis and therapy of reflux esophagitis. Jpn J Gastroenterol Surg 12:486–491CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • N. Maekawa
    • 1
  • K. Sakai
    • 1
  • M. Higashino
    • 1
  • H. Osugi
    • 1
  1. 1.The Second Department of SurgeryOsaka City University Medical SchoolAbenoku, Osaka 545Japan

Personalised recommendations