[Stage-adapted reconstruction of the stomach after gastrectomy]

The only realistic chance of a cure for cancer of the stomach is gastrectomy with a wide margin of clearance. The question as to what constitutes the ideal reconstruction of a substitute stomach, however, remains unanswered. A number of prospective randomized studies show that patients operated on in curative intent and with a good long-term prognosis, should be given a substitute stomach in the form of a pouch constructed from small bowel, with restoration of duodenal passage. On account of the shorter operating time, patients receiving palliative surgery should be treated with a simple oesophagojejunostomy without such a small-bowel pouch substitute stomach.