TOTAL GASTRECTOMY WITH REPLACEMENT UTILIZING THE TRANSVERSE COLON

Abstract

TOTAL gastrectomy is being increasingly favored for use in all cases of gastric cancer. Carcinoma may spread for considerable distances within the wall of the stomach, and it may extend into the adjacent duodenum and esophagus. Recurrences following subtotal gastrectomy for carcinoma develop at the anastomotic site in about three-fourths of cases. However, total removal of the stomach has produced a disabling state in many patients. Most of such patients fail to gain weight. As a result of lack of reservoir space for ingested foods, an ordinary quantity of food cannot be taken at one time. After the usual methods of reconstruction, ingested food is deviated away from the duodenum and first portion of jejunum. Protein digestion appears to remain adequate, and those totally gastrectomized patients who have difficulty with steatorrhea and diarrhea appear to suffer from the too rapid emptying of the jejunum rather than from an incompleteness or