Total gastrectomy for gastric carcinoma: a clinical, radiological and laboratory assessment of different procedures and of a new method of gastric reconstruction.

Debate continues as to what type of reconstruction, after Total Gastrectomy, might be considered next to perfect. A retrospective analysis of 118 of these operations is carried out by the Author, comparing the experience obtained with 79 reconstructions by a newly developed technique (LYGIDAKIS method), 12 L.AWRENCE’s pouches, 12 Roux-en-Y esophagojejunostomies, 10 end-to-side esophagojejunostomies and 5 esophagoduodenostomies. Utilizing a physiological test meal (Galactomine 18-Raybar), the Author evaluated 20 long term survivors: 5 with LYGIDAKIS method, 5 with LAWRENCE pouch, 5 with Roux -en-Y reconstruction and 5 with simple end-to-side esophagojejunostomy. Analysing parameters such as development of dumping, diarrhoea, pouch emptying time, small bowel transit time and colonic emptying time, conclusion is made about the superiority of the reconstructive technique described in this papel.