[Intestinal pouches: gastric reconstruction]. / Intestinale Pouches: Magenersatz.
Chirurg
; 70(5): 520-9, 1999 May.
Article
em De
| MEDLINE
| ID: mdl-10412596
ABSTRACT
Reconstruction of the intestinal passage after a total gastrectomy is usually based on a direct esophagojejunostomy with end-to-side implantation of the afferent loop. The second principle of reconstruction is based on preservation of the duodenal passage. Long-term problems such as weight loss and malnutrition are further considerations that lead to the concept that gastric reconstruction should have the form of a reservoir. In addition to the construction of the reservoir itself, the clinical concern of avoiding gastroesophageal reflux is a further requirement for the choice of reconstruction type. Diversion of the duodenal content via a Roux-en-Y end-to-side anastomosis is considered to be the standard procedure. Interposition of a sufficiently long duodenal loop with maintenance of the duodenal passage also has the effect of preventing duodenal reflux. A theoretical advantage of this procedure is the linking of the motility of the duodenum with that of the interposed segment with improved synchronization of the aboral nutrient passage. When one considers complicated reconstructive procedures, the present literature suggests construction of a pouch is definitely functionally superior to the simple esophagojejunostomy. Whether the duodenal passage should be maintained or whether a Roux-Y technique should be used is a question that is still open for discussion.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Duodeno
/
Esôfago
/
Estomas Cirúrgicos
/
Gastrectomia
/
Jejuno
Limite:
Humans
Idioma:
De
Revista:
Chirurg
Ano de publicação:
1999
Tipo de documento:
Article