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ObjectiveThe authors evaluated ileocolon interposition as a substitute stomach after total gastrectomy (TG) or proximal gastrectomy (PG). Summary Background DataAlthough the jejunum frequently is used for reconstruction to create a substitute stomach after TG or PG, there are few reports on ileocolon interposition. MethodsThe authors performed ileocolon interposition in 47 patients who underwent TG (N = 18) or PG (N = 29) for malignant gastric lesion and evaluated the function of this structure as a substitute stomach using esophagoscopy, manometry, pH-metry, emptying time, oral glucose tolerance test (OGTT), and postoperative body weight changes. ResultsNo patient reported any reflux symptoms or showed endoscopic findings of reflux esophagitis. These results were well supported by manometry and acid loading pH-metry. Emptying time and OGTT showed good capacity as a reservoir of food, and the postoperative body weight averaged more than 90% of preoperative weight. Clinically, no significant difference between these two groups was recognized during long-term follow-up for up to 12 years after operation. There were no cases of direct operative death, and the 5-and 10-year survival rates were 64.7% and 40.2%, respectively. Conclusions lleocolon interposition after TG or PG has the advantages of preventing postoperative reflux esophagitis and of providing functional replacement of the stomach as a reservoir for ingested food.Although many types of reconstruction of the alimentary tract after total gastrectomy (TG) or proximal gastrectomy (PG) have been reported, the question of which would be the ideal reconstructive procedure for a given patient still is a matter of controversy. After TG or PG, both the ability to prevent esophageal reflux and the function of the stomach to retain food are lost. Therefore, a reconstruction method that would both prevent reflux esophagitis and also provide a reservoir function for food in the reconstructed alimentary tract would be highly desirable. 139Address reprint requests to Takashi Sakamoto, M.D., Second
ObjectiveThe authors evaluated ileocolon interposition as a substitute stomach after total gastrectomy (TG) or proximal gastrectomy (PG). Summary Background DataAlthough the jejunum frequently is used for reconstruction to create a substitute stomach after TG or PG, there are few reports on ileocolon interposition. MethodsThe authors performed ileocolon interposition in 47 patients who underwent TG (N = 18) or PG (N = 29) for malignant gastric lesion and evaluated the function of this structure as a substitute stomach using esophagoscopy, manometry, pH-metry, emptying time, oral glucose tolerance test (OGTT), and postoperative body weight changes. ResultsNo patient reported any reflux symptoms or showed endoscopic findings of reflux esophagitis. These results were well supported by manometry and acid loading pH-metry. Emptying time and OGTT showed good capacity as a reservoir of food, and the postoperative body weight averaged more than 90% of preoperative weight. Clinically, no significant difference between these two groups was recognized during long-term follow-up for up to 12 years after operation. There were no cases of direct operative death, and the 5-and 10-year survival rates were 64.7% and 40.2%, respectively. Conclusions lleocolon interposition after TG or PG has the advantages of preventing postoperative reflux esophagitis and of providing functional replacement of the stomach as a reservoir for ingested food.Although many types of reconstruction of the alimentary tract after total gastrectomy (TG) or proximal gastrectomy (PG) have been reported, the question of which would be the ideal reconstructive procedure for a given patient still is a matter of controversy. After TG or PG, both the ability to prevent esophageal reflux and the function of the stomach to retain food are lost. Therefore, a reconstruction method that would both prevent reflux esophagitis and also provide a reservoir function for food in the reconstructed alimentary tract would be highly desirable. 139Address reprint requests to Takashi Sakamoto, M.D., Second
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