Long-term clinical and endoscopic assessment after total gastrectomy for cancer

Progressive malnutrition has been reported as a long-term consequence of total gastrectomy (TG), possibly related to the mode of reconstructing the intestine. In reviewing our personal experience (1975-Sept. 91), we attempted to correlate the reconstructive technique used with the subsequent course of the patient. A consecutive series of 62 TGs (59 adenocarcinomas, 3 lymphomas) in 38 males and 24 females 59 +/- 11 (m Mean +/- SD) years old was reviewed. Preoperative and "follow-up" evaluations, including upper gastrointestinal series and/or endoscopic examination, complete blood count, serum and liver biochemistry profiles, serum iron and plasma transferrin, oral GTT, USG or CT scan, actual and ideal body weight (IBW Life Extension Institute of New York), and "performance status" assessments, were prospectively documented. The follow-up symptoms were classified as per Cuschieri's scoring system. The endoscopic esophageal mucosa assessments were documented as well. Among 56 patients surviving operation, 34 were available, without tumor recurrence, for long-term (12-132 months) evaluation. A Roux-en-Y loop reconstruction had been performed in 23, 5 with a Hunt-Lawrence pouch; an isoperistaltic, esophagoduodenal, jejunal interposition (IR) was performed in 9, 4 with a Kock pouch; and an omega loop reconstruction was performed in 2. A 60-70-cm-long jejunal limb was always utilized.(ABSTRACT TRUNCATED AT 250 WORDS)