Reconstruction After Proximal Gastrectomy Using a Stapled, U -Shaped Jejunal Pouch

Abstract

Recently, pouch reconstruction has been reported to improve quality of life and functional results after surgery for gastric cancer.1,2 Currently, proximal gastrectomy with jejunal interposition or gastroesophagostomy is performed for early gastric cancer in the upper part of the stomach. This results, however, in insufficient capacity, difficulty with subsequent endoscopic examinations, and a high incidence of reflux esophagitis. Kameyama and associates3 have reported a new method of reconstruction using a jejunal pouch after proximal gastrectomy. Unfortunately, this procedure is complicated and takes a long time to complete. In particular, an end-to-end anastomosis between the gastric remnant and the jejunal pouch is performed by hand. Also, no antireflux procedure is used. We developed a new technique to create a U-shaped jejunal after proximal gastrectomy using stapling devices to avoid these problems.