ABOUT THE RESULTS OF ESOPHAGOJEJUNOGASTROPLASTY IN SURGICAL TREATMENT OF CANCER OF THE PROXIMAL PART STOMACH

Sheleshko P. V., Skripnikov N. S., Bashtan V. P., Chornobay A. V., Gupta Akshay

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. In 40-45% of gastric cancer patients with tumors of the top of his part feasible proximal subtotal resection with formation of esophageal-gastric anastomosis. According to the literature in these anastomosis due to insufficiancy sutures stated high postoperative mortality. For this reason, cancer of the proximal part stomach preference gastrectomy because esophago- junostomy reliably than esophagogastrostomy. However, in 4-7% of patients after gastrectomy, the cause of death can not be a recurrence of cancer, and not giving a progressive depletion of correction. An effective method to reduce the unwanted effects of operations for cancer of the proximal part stomach is jejunoplasty. Purpose of the study. To analyses the effectiveness in comparison with other methods esophagojejunogastroplasty improved method, which is registered in the state register of patents of Ukraine. Material and methods. Esophagojejunogastroplasty improved method in proximal gastric resection for cancer, unlike other methods is provided the use of a continuous loop of the small intestine. At the same time it carried out a number of tasks, requirements for such operations: the need to maintain sufficient radical intervention, taking into account the stage of the cancer and form of growth; in comparison with other techniques such technique jejunoplasty simplify operations with decreasing duration of their execution; give sufficient reliability formed anastomosis in plan of consistency satures and prophylaxis after surgical reflux esophagitis; exclude paresis moved intestine. According to the process it has been operated on 11 patients aged 42 to 67 years for cancer stage II-III of the proximal stomach. Three patients in connection with the localization of the tumor in the proximal stomach subcardia its resection was performed at the level of the maximum subtotal. In four patients due to the transition of the tumor to the esophagus combined thoraco-abdominal access has been applied. All operated were not complications in the early postoperative period, and later on when observing them from 1 month to 2 years. In plan of complex treatment of all patients was performed postoperative chemotherapy. Conclusions. Method esophagojejunogastroplasty continuous small intestine in contrast to the known techniques simplifies the technique of such operations. Improve the immediate postoperative results with proximal gastric resection, because the esophagus to the small intestine anastomoses without tension connected organs. Provides enough physiology of proximal gastric resection, even at extremely subtotal as excluded total removal of the stomach. Not disturbed radicalism operations for cancer of the proximal part of the stomach, as there is no need for leaving the stump of the stomach several large scale due to the vagueness of the boundary value of the tumor border.

cancer of the proximal part stomach, esophagojejunogastroplasty, anastomosis, effectiveness

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