Clinical Application And Surgical Technique Of GI Tract Reconstruction With Jejunal Interposition After Total Gastrectomy

Background and objective: Gastric cancer is one of the leading causes of cancer death in china. Although there have been lots of research in the field of diagnosis and treatment of gastric cancer but still the outcome is not so satisfactory. One of the main reason of it is by the time gastric cancer is diagnosed it is too late for the treatment.Jejunal interposition combined withρpouch reconstruction after complete gastric resection could either keep the preservation of the duodenal passage or be an appropriate replacement gastric reservoir, but more anastomoses could increase the risk of morbidity and operation time. We describe a modified technique to perform the esophagojejunostomy, jejunodenostomy,ρpouch and jejunoanastomosis with circular stapling devices. We have used this technique for more than 2 years without complications related to the stapled anastomosis. Fourteen patients with gastric cancer underwent this procedure after total gastrectomy. This technique may reduce the time of reconstruction of anastomosis without interfering in its final result. Our improved technique with circular staplers is a convenient, safe and reliable procedure.Objective: The main aim of this study is to introduce the new Surgical Technique of GI Tract reconstruction with jejunal interposition after total gastrectomy and a retrospective study of surgical conditions and preliminary outcome was conducted in patients undergone GI tract reconstruction with jejunal interposition after total gastrectomy during 2005-2008.Methods: Retrospective study of surgical conditions and preliminary results in patients who were undergone GI Tract reconstruction with jejunal interposition after total gastrectomy during 2005-2008.Results: We have successfully used this technique in 14 patients operated for gastric cancer between 2005-2008. The total operation time of the reconstruction of each patient is about 15 to 25 minutes and average less than 20 minutes. There was no postoperative morbidity related to jejunal interposition combined withρpouch reconstruction. The postoperative routine checks of the anastomosis with a water-soluble contrast media (Gastrograffin) showed no leakage and the contrast media passed smoothly into the distal jejunum. Conclusions: This technique may reduce the time of reconstruction of anastomosis without interfering in its final result. Our improved technique with circular staplers is a convenient, safe and reliable procedure.