GASTRIC RESECTION WITH ROUX-EN-Y ANASTOMOSIS IN THE PATHOLOGY OF THE UPPER DIGESTIVE TRACT
Abstract:
We conducted a retrospective study on 138 patients from a single surgeon’s experience with the aim to analyze the different types of gastric resection performed for both benign and malignant diseases of the upper gastrointestinal tract and to compare the different reconstructive techniques using the Roux-en-Y loop and their postoperative complications and mortality. The restoration of the duodenal passage had no negative influence on the postoperative results, while the multivisceral resections, the splenectomy and the palliative resections for gastric carcinoma increased the mean hospital stay and were associated with a higher incidence of complications and mortality. The gastric resection with Roux-en-Y reconstruction is an operation which can be performed in a various range of diseases of the upper gastrointestinal tract, the gastric cancer being nowadays its main indication. Because of the lower rate of postoperative complications, the subtotal gastrectomy is preferred over the total gastrectomy. The splenectomy in the cases of gastric cancers is only required when there are metastatic lymph nodes in the splenic hilum. Multivisceral resections are indicated only when R0 margins can be obtained. The restoration of the duodenal passage is a feasible alternative method of reconstruction after gastrectomy.
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