Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.

Detalhes bibliográficos
Autor(a) principal: Fernandes, F V
Data de Publicação: 1990
Outros Autores: Mascarenhas, L, da Costa, E B, Branco, A, Mendonça, J L
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4571
Resumo: Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.
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spelling Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.Gastrectomia total com construção de um neo estômago com jejuno. Estudo retrospectivo de 120 doentes.Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.Ordem dos Médicos1990-08-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4571oai:ojs.www.actamedicaportuguesa.com:article/4571Acta Médica Portuguesa; Vol. 3 No. 4 (1990): Julho - Agosto; 213-20Acta Médica Portuguesa; Vol. 3 N.º 4 (1990): Julho - Agosto; 213-201646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4571https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4571/3589Fernandes, F VMascarenhas, Lda Costa, E BBranco, AMendonça, J Linfo:eu-repo/semantics/openAccess2022-12-20T11:03:49Zoai:ojs.www.actamedicaportuguesa.com:article/4571Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:55.021525Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
Gastrectomia total com construção de um neo estômago com jejuno. Estudo retrospectivo de 120 doentes.
title Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
spellingShingle Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
Fernandes, F V
title_short Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
title_full Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
title_fullStr Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
title_full_unstemmed Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
title_sort Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients.
author Fernandes, F V
author_facet Fernandes, F V
Mascarenhas, L
da Costa, E B
Branco, A
Mendonça, J L
author_role author
author2 Mascarenhas, L
da Costa, E B
Branco, A
Mendonça, J L
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Fernandes, F V
Mascarenhas, L
da Costa, E B
Branco, A
Mendonça, J L
description Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.
publishDate 1990
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 3 No. 4 (1990): Julho - Agosto; 213-20
Acta Médica Portuguesa; Vol. 3 N.º 4 (1990): Julho - Agosto; 213-20
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