33. Application of the total (residual) gastrectomy jejunum anastomosis of esophageal Roux-en-y

Objective: To investigate the total ( residual ) gastrectomy jejunum anastomosis of esophageal Roux-en-y safety and postoperative complications.
Methods: Retrospective analysis of our hospital in 2005 January to 2012 March a total of 995 cases of total gastrectomy and gastric stump resection of the jejunum anastomosis of esophageal Rouxeny case information.
Results: All cases were successful implementation of the total (residual) gastric resection, no death during the operation. (I) In all cases, average operation time: 3±1.5 h, the average bleeding volume in operation: 200±45 mL, the average length of stay: 13±2 D; (II) patients after 3-5 D began a little meal flow of juice, 6-8 D began to frequent small meals eating half juice flow. After 12 days every 4-6 times ate semifluid juice diet, daily intake of >1,000 g, each meal >300 g, most patients feel good and discharge; (III) discharge the appetite increases gradually, after 1 years 109 in most patients quality of life satisfaction, eat soft food sessile choke, on the abdominal pain and progressive weight loss and other symptoms, the individual cases are mild gastrointestinal symptoms, such as satiety, anorexia, dyspepsia symptoms. (IV) all patients had no postoperative anastomotic fistula occurred in1cases, reflux esophagitis and dumping syndrome and other complications; (V) there were 7 cases of postoperative1 months a soft diet have sense of obstruction, anastomotic stenosis symptoms, most of the patients symptoms gradually disappeared or relieved. Only 1cases due to obstruction symptom exacerbation patients can only eat flow of juice, in the endoscopic view of anastomotic stenosis after open operation is, confirmed as distance from the esophagus jejunum anastomosis of jejunum 12 cm adhesion and angulated adhesion lysis after obstruction symptoms disappeared; (VI) there were 2 cases of postoperative day appear anastomosis mouth bleeding after endoscopic hemostasis and hemostatic drugs after treatment cessation of bleeding.
Conclusions: The total (residual) gastrectomy jejunum anastomosis of esophageal Roux-en-y is simple, safe, less complications.