A team from Switzerland evaluated the outcome following replacement of the stomach with an ileocecal segment.
A total of 20 patients undergoing ileocecal interpositional graft (13 subdiaphragmatic reconstruction, 7 intrathoracic reconstruction) after gastrectomy were included in the trial.
The researchers prospectively analyzed the quality-of-life outcome, operative and postoperative morbidity, body weight, reflux, and dumping symptoms in these patients.
Mean follow-up was 6 months.
| Ileocecal interpositional graft reduced postoperative reflux and dumping symptoms.
| International Journal of Colorectal Disease |
In a smaller series of 9 patients, functional tests such as gastric emptying measurements, glucose tolerance tests, and manometry of the gastric substitute were performed.
The mean gastrointestinal quality-of-life index in the subdiaphragmatic reconstruction group 114, and that in the intrathoracic reconstruction group was 106.
No patients in the subdiaphragmatic reconstruction group and 2 of 7 patients in the intrathoracic reconstruction group noted mild reflux and dumping symptoms.
The team found that, in the smaller series of 9 patients, gastric emptying time was faster in the intrathoracic group. However, no difference in plasma glucose level was found between the two groups.
Dr J. Metzger, of the Basel University Hospital, Basel, concluded on behalf of fellow authors, "Reconstruction after gastrectomy with an ileocecal interpositional graft achieves good quality of life with an acceptable morbidity.
"The technique seems to reduce the occurrence of postoperative reflux and dumping symptoms."