[Reconstruction techniques after partial and total gastric resection]

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Context:

• Gastric resections are integral to oncological treatment, often within multimodal concepts.
• Reconstruction methods vary based on the extent of gastric resection (total, proximal, distal/subtotal).
• Minimally invasive and robotic techniques have expanded anastomotic possibilities without fundamentally altering reconstruction procedures.

Purpose:

• To review current gastric surgery reconstruction techniques.
• To discuss the impact of different reconstruction methods on functional outcomes and quality of life.
• To highlight specific reconstruction strategies for total and proximal gastrectomy.

Summary:

• Reconstruction after gastric resection depends on the extent of surgery, with various methods available.
• While minimally invasive surgery has broadened anastomotic options, fundamental reconstruction principles remain.
• Preserving gastric residue or employing specific reconstructions like jejunal pouches (for total gastrectomy) or double-tract reconstruction (for proximal gastrectomy) can mitigate functional and nutritional deficits, including dumping symptoms and impaired quality of life.

Impact:

• Jejunal pouch placement after total gastrectomy significantly reduces dumping symptoms.
• Double-tract reconstruction offers functional advantages over Roux-en-Y for proximal gastrectomy.
• Optimizing reconstruction techniques is crucial for improving postoperative health-related quality of life after gastric cancer surgery.