Reconstructive Surgery on Gastrointestinal Tract After Gastrectomy

The problem of retaining the quality of life in patients after gastrectomies remains important and actual. In the last few years it is thought that it is due to the amelioration of surgical techniques and wide implementation of mechanical suture. However, there is a trend to the simplification and unification of surgical techniques to increase their reliability which appeared to be an obstacle for the further development of gastric-intestinal surgery, which is thought to be an important approach for prevention of complications after conventional gastric surgery and allows to considerably increase the quality of a patient’s life. A study of results regarding the usage of surgical methods in reflux esophagitis, dumping syndrome and dysphagia after total removal of the stomach was conducted. Among 2119 patients operated owing to stomach cancer (T2 - T4), all patients who underwent gastrectomy with original anti-reflux anastomosis and different forms of enteric reconstruction, 17.0%-gastrectomies were combined, 14.0%-palliative, 7.0%-palliative-combined. Complications after operation were 20%, mortality rate 2.7%, frequency of inconsistence regarding esophageal anastomosis were 0.76%. The mechanism of anti-reflux action of muff like anastomosis is complex and concludes in substantial function of cardia and based on forming analogues of stomach ache and gastric air bubbles. Due to these features anti-reflux effect of anastomosis is preserved in the remaining life of the patient. The frequency of reflux esophagitis in various periods after the surgery developed in 7.7% of the patients, dumping syndrome in 6.6% of the patients, scar stenosis of anastomosis in 6.1%. Studying the quality of the patients lives with the implementation of index GLQI confirmed the high quality of patients lives and the efficiency of the elaborate techniques.