[Jejunum segment interposition after total proximal gastrectomy (by the 70th anniversary of the Merendino-Dillard procedure)].

OBJECTIVE

To evaluate safety and efficacy of jejunum segment interposition after proximal gastric resection.

MATERIAL AND

METHODS

There were 80 jejunum segment interpositions after proximal gastric resection in 2012-2023. Primary subtotal proximal gastric resection was performed in 70 (87.5%) patients, resection of esophagogastrostomy in 9 (11.2%), gastric bypass surgery - in 1 (1.3%). The indications for surgery were cancer in 66 (82.5%) patients, recurrence of cancer in esophagogastrostomy - 2 (2.5%), postgastrectomy diseases - 12 (15.0%). Mean age of patients was 62 years. There were 51 (63.8%) men and 29 (36.2%) women.

RESULTS

In early postoperative period, 8 (10.0%) patients developed complications. Failure of esophagojejunostomy occurred in 5 (6.3%) cases, subdiaphragmatic abscess - in 1 (1.3%) patient. Another (1.3%) patient had jejunum insert necrosis that required its extirpation and direct esophagogastrostomy. One (1.3%) patient died from non-occlusive mesenteric ischemia with intestinal necrosis on the 3rd day after surgery. There were no long-term specific complications related to jejunum segment. Reflux esophagitis was recorded in 2 (3.6%) out of 56 patients.

CONCLUSION

Jejunum segment interposition after proximal gastric resection is a relatively safe technique preventing severe reflux esophagitis.