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Ileocolon interposition as a substitute stomach after total or proximal gastrectomy
T Sakamoto1, M Fujimaki, K Tazawa
1Second Department of Surgery, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani, Japan.
Annals of Surgery
|August 1, 1997
Summary
Ileocolon interposition effectively replaces the stomach after gastrectomy, preventing reflux esophagitis and maintaining reservoir function. This surgical technique shows promising long-term results and survival rates.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Digestive System Surgery
Background:
- Jejunal interposition is common after total or proximal gastrectomy, but ileocolon interposition is less reported.
- Evaluating alternative reconstruction methods is crucial for improving post-gastrectomy outcomes.
Purpose of the Study:
- To assess the efficacy of ileocolon interposition as a substitute stomach following total gastrectomy (TG) or proximal gastrectomy (PG).
- To evaluate the functional outcomes and long-term safety of this reconstructive approach.
Main Methods:
- Ileocolon interposition was performed in 47 patients (18 TG, 29 PG) for gastric malignancy.
- Functional assessment included esophagoscopy, manometry, pH-metry, emptying time, oral glucose tolerance test (OGTT), and body weight monitoring.
Main Results:
- No reflux esophagitis was observed, confirmed by manometry and pH-metry.
- The ileocolon segment demonstrated good reservoir capacity, with patients maintaining over 90% of their preoperative body weight.
- Long-term follow-up (up to 12 years) showed no significant differences between TG and PG groups, with 5- and 10-year survival rates of 64.7% and 40.2% respectively.
Conclusions:
- Ileocolon interposition is a viable option for gastric reconstruction after TG or PG.
- This method effectively prevents postoperative reflux esophagitis and preserves gastric reservoir function.
- The technique offers favorable functional outcomes and acceptable long-term survival rates.