Distal pouch reconstruction with transverse jejunoplasty after experimental gastrectomy

• Verfasst von: Hackert, Thilo [VerfasserIn]
• Verfasst von: Dovzhanskiy, Dmitriy I. [VerfasserIn]
• Verfasst von: Heiser, Felix [VerfasserIn]
• Verfasst von: Bergmann, Greta [VerfasserIn]
• Verfasst von: Schneider, Lutz [VerfasserIn]
• Verfasst von: Werner, Jens [VerfasserIn]
• Titel: Distal pouch reconstruction with transverse jejunoplasty after experimental gastrectomy
• Verf.angabe: Thilo Hackert, Dmitriy I. Dovzhanskiy, Stefan Tudor, Felix Heiser, Greta Bergmann, Hussein Soliman, Lutz Schneider, Jens Werner
• E-Jahr: 2012
• Jahr: January 2012
• Umfang: 5 S.
• Teil: volume:397
• Teil: year:2012
• Teil: number:1
• Teil: pages:63-67
• Teil: extent:5
• Fussnoten: Published online: 15 July 2011 ; Gesehen am 18.10.2018
• Titel Quelle: Enthalten in: Langenbeck's archives of surgery
• Ort Quelle: Berlin : Springer, 1948
• Jahr Quelle: 2012
• Band/Heft Quelle: 397(2012), 1, Seite 63-67
• ISSN Quelle: 1435-2451
• DOI: doi:10.1007/s00423-011-0826-3
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Gastrectomy
• Sach-SW: Jejunal pouch
• Sach-SW: Jejunoplasty
• Sach-SW: Reconstruction
• K10plus-PPN: 1582077355

Abstract

PurposeVarious reconstruction methods with or without reservoir formation after total gastrectomy have been established. Transverse intestinoplasty has benefits as a functional peristalsis modification in rectal resections. In this study, we evaluate a distal pouch combined with a transverse jejunoplasty compared to standard Roux-en-Y reconstruction.MethodsTotal gastrectomy was performed on 23 pigs randomly assigned to 3 reconstruction groups—group 1 (n = 7): esophagojejunostomy without a pouch, group 2 (n = 8): esophagojejunostomy with a distal pouch, and group 3 (n = 8): distal pouch with a transverse jejunoplasty. Seven days postoperatively, weight was measured, and X-ray examinations were conducted for 1 h after oral contrast medium application. Blood glucose levels after oral glucose intake and the volume of the pouch loop were evaluated.ResultsUpper jejunal passage was delayed and the mean volume of the jejunal loop increased by pouch formation compared to controls (p < 0.05). Body weight was the best for the pouch group with jejunoplasty (−1.9 ± 0.8% vs. pouch alone −3.3 ± 2.4% vs. no pouch −7.5 ± 2.1%, p < 0.05).ConclusionsThe distal jejunal pouch after total gastrectomy offers advantages with respect to bowel passage and postoperative nutrition status compared to standard Roux-en-Y reconstruction. The combination of a distal pouch and transverse jejunoplasty may provide additional functional benefits.