Abstract The ileocecal interpositional graft is an alternative method for replacing the distal esophagus and the stomach. A pedunculated ileocecal interpositional graft rotated 180° clockwise and placed across the hiatus between the proximal esophagus and the duodenum could act as a reservoir and protect against reflux (ileocecal valve) while preserving the duodenal passage. Two patients underwent this operation (the first patient has been observed for 12 postoperative months). We also used this technique to replace the stomach alone below the diaphragm, a technique that had been abandoned in the surgical literature since 1952, although the concept and initial experiences were already promising at that time. In favor of these attractive features of the ileocecal interpositional graft as gastric replacement, we have begun a controlled examination of this method. Arch Surg. 1997;132:1038-1042 References 1. Adams JF. The clinical and metabolic consequences of total gastrectomy . Scand J Gastroenterol . 1967;2:137-149.Crossref 2. Bradley EL, Isaacs J, Hersh T, Davidson ED, Millikan W. Nutritional consequences of total gastrectomy . Ann Surg . 1975;182:415-429.Crossref 3. Olbe L, Lundell L. Intestinal function of total gastrectomy and possible consequences of gastric replacement . World J Surg . 1987;11:713-719.Crossref 4. Belsey R. Reconstruction of the esophagus . Ann R Coll Surg Engl . 1983;65:360-364. 5. Hölscher AH, Voit H, Suttermann G, Siewert JR. Function of the intrathoracic stomach as esophageal replacement . World J Surg . 1988;12:835-844.Crossref 6. Buhl K, Lehnert T, Schlag P, Herfarth C. Reconstruction after gastrectomy and quality of life . World J Surg . 1995;19:558-564.Crossref 7. Nakane Y, Okumura S, Akehira K, et al. Jejunal pouch reconstruction after total gastrectomy for cancer: a randomized controlled trial . Ann Surg . 1996:222:27-35.Crossref 8. Liedman B, Andersson H, Berglund B, et al. Food intake after gastrectomy for gastric carcinoma: the role of a gastric reservoir . Br J Surg . 1996;83:1138-1143.Crossref 9. von Flüe M, Harder F. A new technique for pouch-anal reconstruction after total mesorectal excision . Dis Colon Rectum . 1994;37:1160-1162.Crossref 10. von Flüe M, Degen L, Beglinger C, Helwig A, Rothenbühler JM, Harder F. Ileocecal reservoir reconstruction with physiological function after total mesorectal cancer excision . Ann Surg . 1996;224:204-212.Crossref 11. Lee CM. Transposition of a colon segment as a gastric reservoir after total gastrectomy . Surg Gynecol Obstet . 1951;92:456-465. 12. Hunnicutt AJ. Replacing stomach after total gastrectomy with right ileocolon . Arch Surg . 1952;65:1-11.Crossref 13. Hagen JA, Peters JH, DeMeester TR. Superiority of extended en bloc esophagogastrectomy for carcinoma of the lower esophagus and cardia . J Thorac Cardiovasc Surg . 1993;106:850-858. 14. Peters JH, DeMeester TR, Stein HJ. Surgical therapy for cancer of the esophagus and cardia . In: Castell DO, ed. The Esophagus . Boston, Mass: Little Brown & Co Inc; 1995:327-331. 15. Lu YIC, Li YM, Gu YZ. Cancer of esophagus and esophagogastric junction . J Thorac Cardiovasc Surg . 1987;107:1067-1072. 16. Miles WE. A method of performing abdominoperineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon . Lancet . 1908;2:1812-1813.Crossref 17. Quigley EMM, Phillips SF, Dent J, Taylor BM. Myoelectric activity and intraluminal pressure of the canine ileocolonic sphincter . Gastroenterology . 1983:85: 1054-1062. 18. Touloukian RJ, Tellides G. Retrosternal ileocolic esophageal replacement in children revisited . J Thorac Cardiovasc Surg . 1994;107:1067-1072.
Archives of Surgery – American Medical Association
Published: Sep 1, 1997
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