Use of a jejunal segment to replace the stomach following total gastrectomy

Murine Tissue-Engineered Stomach Demonstrates Epithelial Differentiation

“…Although this has contributed to an improved survival rate (>90%) for early gastric cancer patients, postgastrectomy morbidity is considerable and quality of life is poor [2]. More than 70 reconstructive procedures have been proposed since Schlatter's initial gastrectomy in 1897 in an effort to address an inadequate food reservoir and lack of gastric physiology [3][4][5][6][7][8]. Studies reviewing these surgical strategies, including pouch formation and the jejunal interposition (Longmire's procedure), have found conflicting evidence regarding quality of life improvement for these patients [7].…”

Gastrectomy with isoperistaltic jejunal parallel pouch in a 15-year-old adolescent boy with gastric adenocarcinoma and autosomal recessive agammaglobulinemia

“…Therefore, we are unable to draw any conclusions in terms of the "optimal type of reconstruction." Because it is known that adult patients with a gastric pouch complain significantly less of dumping and heartburn and show substantially better food intake postoperatively with a better health-related quality of life compared with conventional reconstruction [24], we decided to perform reconstruction with a jejunal pouch instead of merely a jejunum segment interposition [25]. The pouch was formed by a jejunal loop interposed between the esophagus and duodenum to form a reservoir to allow more intense oral alimentation and-in contrast to a Hunt-Lawrence pouch [26]-to maintain duodenal continuity.…”

Invited commentary

“…However, Hays and Clark [1] constructed a triple jejunal pouch and found caloric and protein intake to be normal, with fecal fat and nitrogen to be likewise normal in 4 patients. Beal, Briggs, and Longmire [2] used a Henley loop between esophagus and duodenum and reported satisfactory weight responses postoperatively. Huguier et al [3] have reported on 6 types of reconstructions in 181 patients.…”