[The choice of an optimal variant in the reconstructive stage of gastrectomy]

The authors analyse 40-year experience in gastrectomy and extirpation of the gastric stump in carcinoma of the stomach. Operations were performed on 742 patients. The results show that the mechanical suture has advantages over the manual suture in the formation of the esophago-intestinal anastomosis. The functional results were found to be best when the continuity of the gastrointestinal tract was restored by establishing the esophago-intestinal anastomosis with a loop of the small intestine isolated according to Roux. Comparative appraisal of end-to-end and end-to-side esophago-intestinal anastomoses revealed the advantages of the last-named in relation to the incidence of postoperative complications and total outcomes. The effect of the surgeon's qualification on the frequency of postoperative complications is discussed.