Aboral Pouch with Preserved Duodenal Passage – New Reconstruction Method after Total Gastrectomy

Horváth, Örs Péter; Kalmár, Katalin; Cseke, László

doi:10.1159/000064575

Cited by 8 publications

(3 citation statements)

References 11 publications

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“…Further randomized trials to determine the optimal method of reconstruction have, therefore, been initiated. In 1999 a group from Hungary started to compare distal jejunal pouch formation with preservation of duodenal transit to Roux‐en‐$\font\ss=cmss10 scaled 1000 \hbox{\ss Y}$ reconstruction43. A Swiss trial initiated by von Flue et al 6, 7.…”

Section: Resultsmentioning

confidence: 99%

Techniques of reconstruction after total gastrectomy for cancer

Lehnert

Buhl

2004

British Journal of Surgery

102

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Section: Resultsmentioning

confidence: 99%

Techniques of reconstruction after total gastrectomy for cancer

Lehnert

Buhl

2004

British Journal of Surgery

102

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“…However, no reconstruction procedures have been reported to meet all the above requirements. 2,[4][5][6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

Comparative Study on Three Types of Alimentary Reconstruction After Total Gastrectomy

Wei

Zheng

et al. 2008

Journal of Gastrointestinal Surgery

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“…The aboral pouch is constructed under the mesocolon as an anisoperistaltic side-to-side anastomosis between the Roux limb and the Y limb, measuring 15 cm in length (Fig. 1) [5].…”

Section: Aboral Pouch With Preserved Duodenal Passage (Ap)mentioning

confidence: 99%

Comparing aboral versus oral pouch with preserved duodenal passage after total gastrectomy: does the position of the gastric substitute reservoir count?

et al. 2008

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ing the duodenum, and respond properly to the changing levels of gastrointestinal hormones and neural information. The science of surgery is nowhere near reaching this ideal. With the gold standard Roux-en-Y reconstruction so far achieved, gastrectomized patients do not suffer from alkaline esophagitis. Different pouch construction methods and reconstructions of the duodenal passage are being trialled to improve functional results.In our previous studies, a Roux-en-Y-based but distally reconstructed pouch-the aboral pouch-was compared to Roux-en-Y reconstruction, as well as being compared to reconstruction with an aboral pouch and duodenal passage preservation [1][2][3][4]. Absorption studies supported pouch construction; gastrointestinal hormone studies suggested the superiority of duodenal passage preservation [4]. In this study, the site of the pouch is examined; two different reconstruction types, the traditional oral pouch and the aboral pouch, are compared. Based on our gastrointestinal hormonal studies, we believe in the superiority of duodenal passage preservation, that is why both pouch reconstructions were performed with duodenal passage preservation. Patients and methods Eligibility criteria and randomizationAll patients with a disease necessitating total gastrectomy were investigated for eligibility to enter the trial. Patients younger than 80 years, who had no historical data of previous bowel resection and in whom kidney and liver function tests had shown normal results, and in whom R0 resection could be performed, were considered eligible. During the operation, after evaluation of the feasibility of both reconstruction methods and clearance for technical resectability, randomization was performed via the envelope selection method. AbstractBackground. Total gastrectomy results in a signifi cant weight loss, different postgastrectomy symptoms, and a reduction in quality of life. Elaborate surgical reconstruction methods are evaluated to improve results. The present study compares two types of reconstructions-an aboral pouch with preserved duodenal passage and an oral pouch with preserved duodenal passage-differing only in the site of the pouch. Methods. Twenty-eight patients entered the study. Primary outcome measures-body weight, body mass index, and quality of life, and secondary outcome measures-serum nutritional parameters, scintigraphic small-intestinal passage, and lipid and carbohydrate absorption were measured 6, 12, and 24 months after surgery. Results. No signifi cant differences were found in anthropometric parameters or in quality of life between the groups. Regarding the secondary outcome measures, albumin levels were higher in the oral pouch group, while protein and immunoglobulin-A levels were higher in the aboral pouch group. Conclusion. The site of the reservoir does not signifi cantly infl uence the outcome after total gastrectomy and reconstruction with a preserved duodenal passage.

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Aboral Pouch with Preserved Duodenal Passage – New Reconstruction Method after Total Gastrectomy

Cited by 8 publications

References 11 publications

Techniques of reconstruction after total gastrectomy for cancer

Techniques of reconstruction after total gastrectomy for cancer

Comparative Study on Three Types of Alimentary Reconstruction After Total Gastrectomy

Comparing aboral versus oral pouch with preserved duodenal passage after total gastrectomy: does the position of the gastric substitute reservoir count?

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