Roux-en-Y gastroenteroanastomosis in the treatment of stenosing and advanced gastric adenocarcinoma

Abstract

BACKGROUND: Gastric cancer is the most common cancer of the digestive tract and approximately 60% of cases are advanced when the patient is first admitted for treatment. AIM: A retrospective analysis of patients with advanced gastric adenocarcinoma, stenosing and unresectable, performing Roux-en-Y gastroenteroanasmosis. METHODS: From January 1998 to December 2009, 62 patients were operated with a mean age of 52.7 years, being 43 males (69.3%). The gastrojejunal anastomosis was latero-lateral, pre-colic and jejuno-jejunoanastomosis end-to-side Roux-en-Y, lying about 50 cm from the stomach. RESULTS: The average hospital stay was 7.5 days. It was reported one death secondary to pneumonia and sepsis (1.6%). Postoperatively, all patients started to eat solids and pastes, with weight gain. The occurrence of frequent vomiting was found in four patients (6,4%). The median survival was 11 months. CONCLUSION: The Roux-en-Y gastroenteroanastomosis is a very good option to prevent the occurrence of enteric and bilious vomiting after palliative surgery, causes weight gain and improved quality of life.

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“…It consists of a precolic side-to-side gastrojejunostomy and a Roux-en-Y end-to-side jejuno-jejunal anastomosis, with an efferent loop measuring about 50 cm. This procedure is usually performed in patients with unresectable malignancy [ 11 ].…”

“…This technique offers shorter surgical time and fewer perioperative complications compared to surgical resection or other bypass procedures. Moreover, Roux-en-Y gastroenteroanastomosis is a surgical approach that can eliminate the alkaline gastritis and its long-term consequences that usually occur in classical gastroenteroanastomosis [ 11 ].…”