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REPLACING STOMACH AFTER TOTAL GASTRECTOMY WITH RIGHT ILEOCOLON

REPLACING STOMACH AFTER TOTAL GASTRECTOMY WITH RIGHT ILEOCOLON Abstract IN THE operation of total gastrectomy, replacement of the stomach with the terminal ileum and right colon appears to offer several advantages: (1) the ileocecal valve prevents regurgitation into the esophagus; (2) the transplaced right colon will accept an average-sized meal; (3) there are no apparent sensitivities of the right colon to ingested food, and (4) interposing the ileocolon between the esophagus and the duodenum with the resultant admixture of mucus to ingested food prevents or decreases adverse effects on the jejunum. After it is determined that total gastrectomy is indicated and feasible, the terminal ileum and right colon are mobilized as if a right colon resection were contemplated. The terminal ileum is transected about 4 in. (10 cm.) from the ileocecal junction. The right colon is transected at or near the hepatic flexure, depending upon the variable right colic artery1 (Fig. 1). The mesentery of the right colon References 1. Dr. John Saunders, Professor of Anatomy, University of California Medical School, made helpful suggestions on the physiology and anatomical variations of the right colon. 2. Hunnicutt, A. J.: Total Gastrectomy for Carcinoma: A New Procedure , Bull. Alameda Co. M. A. , (Sept.) 1949, p. 16 3. reprinted, M. Rec. & Ann. 43:1102 [ (Dec.) ] 1949 4. Lawson, T. C., in discussion on Judd, E. S., Jr., and Hoon, J. R.: Total Gastrectomy: An Investigation of the Merits of End to End Esophagoduodenostomy , Arch. Surg. 61:110 ( (July) ) 1950. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

REPLACING STOMACH AFTER TOTAL GASTRECTOMY WITH RIGHT ILEOCOLON

A.M.A. Archives Surgery , Volume 65 (1) – Jul 1, 1952

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Publisher
American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1952.01260020013001
Publisher site
See Article on Publisher Site

Abstract

Abstract IN THE operation of total gastrectomy, replacement of the stomach with the terminal ileum and right colon appears to offer several advantages: (1) the ileocecal valve prevents regurgitation into the esophagus; (2) the transplaced right colon will accept an average-sized meal; (3) there are no apparent sensitivities of the right colon to ingested food, and (4) interposing the ileocolon between the esophagus and the duodenum with the resultant admixture of mucus to ingested food prevents or decreases adverse effects on the jejunum. After it is determined that total gastrectomy is indicated and feasible, the terminal ileum and right colon are mobilized as if a right colon resection were contemplated. The terminal ileum is transected about 4 in. (10 cm.) from the ileocecal junction. The right colon is transected at or near the hepatic flexure, depending upon the variable right colic artery1 (Fig. 1). The mesentery of the right colon References 1. Dr. John Saunders, Professor of Anatomy, University of California Medical School, made helpful suggestions on the physiology and anatomical variations of the right colon. 2. Hunnicutt, A. J.: Total Gastrectomy for Carcinoma: A New Procedure , Bull. Alameda Co. M. A. , (Sept.) 1949, p. 16 3. reprinted, M. Rec. & Ann. 43:1102 [ (Dec.) ] 1949 4. Lawson, T. C., in discussion on Judd, E. S., Jr., and Hoon, J. R.: Total Gastrectomy: An Investigation of the Merits of End to End Esophagoduodenostomy , Arch. Surg. 61:110 ( (July) ) 1950.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Jul 1, 1952

References