[Study of the antireflux action of the Roux-en-Y jejunal loop in reconstruction after gastrectomy and nutritional status in the follow-up]

Abstract

The Roux-en-Y recostruction after total or subtotal gastrectomy for gastric cancer is frequently performed to prevent esophageal alkaline reflux. Also after total gastrectomy and end-to-side gastrojejunal anastomosis, as usual in former experience, the alkaline reflux can be efficaciously treated by conversion in an esophago-jejunal Roux-en-Y procedure. The main factor preventing reflux is the length of jejunal loop, at least of 35-40 cm. The recostruction with a Roux-en-Y jejunal loop offers the advantage to meet together two primary requirements: the restoration of digestive travel from esophagus to intestine, and the prevention of on alcaline reflux esophagitis, both with relevant simplicity and without a time-consuming surgical technique. Also as a consequence the postoperative morbidity is decreased. The obvious suitable requirement is a sufficient lenght of the jejunal loop for a reservoir of the ingested food and to oppose the antiperistaltic jejunal movements thanks to the effects of the new activated jejunal pace-maker.