Total gastrectomy with intestinal J-pouch: paradigms past and present
https://doi.org/10.17238/2072-3180-2025-2-55-64
Abstract
Introduction. A comparative analysis of the immediate and long-term results of various reconstruction options for gastrectomy according to Ru allowed us to present the intestinal reservoir as a functional element of the digestive tube with a pronounced protective function, contributing to a more effective adaptation of digestive processes after surgical removal of the stomach.
Research materials and methods. To determine the characteristic features of the postoperative course, the immediate and functional results of gastrectomy with the formation of a proximal intestinal reservoir on the Ru loop, a retro- and prospective comparative multiparametric cohort analysis of the course of the immediate and long-term postoperative period was performed in 133 patients (average age 63.3±6.1 years) who underwent gastrectomy with a general scheme of reconstruction according to Ru and various variants esophago-enterostomy, for the period from 2019 to 2024.
Results. The formation of a proximal intestinal reservoir on the loop with invagination transverse esophago-enteroanastomosis was accompanied by a minimal number of intra- and extra-abdominal complications, no deaths, early recovery of the motor evacuation function of the digestive tube, a minimal number of patients with postoperative reflux esophagitis and a significantly higher quality of life.
Conclusion. The presented functional results of using the technique of forming a proximal intestinal reservoir on a loop with invagination transverse esophago-enteroanastomosis make it possible to consider the use of this surgical technique in a modern surgical clinic as legitimate and appropriate.
About the Authors
M. A. Evseev
FGBU "National Medical Research Center of High Medical Technologies named after A.A. Vishnevsky" of the Russian Ministry of Defense
Russian Federation
Russian Federation
Evseev Maxim Alexandrovich – Physician, Doctor of Medical Sciences, Professor, Deputy Head (for Research)
143420, Krasnogorsk, Moscow region, Novy settlement, ter. 3 of the Vishnevsky Central Medical School, 1.
V. A. Musailov
FGBU "National Medical Research Center of High Medical Technologies named after A.A. Vishnevsky" of the Russian Ministry of Defense
Russian Federation
Russian Federation
Musailov Vitaly Anatolyevich – Doctor of Medicine, Doctor of Medical Sciences, Head of the Department
143420, Krasnogorsk, Moscow region, Novy settlement, ter. 3, A.A. Vishnevsky Central Medical Center, 1.
V. S. Fomin
FGBOU HE "Russian University of Medicine" of the Ministry of Health of Russia;
GBUZ GKB named after V.V. Veresaev DZM
Russian Federation
Russian Federation
Fomin Vladimir Sergeevich – Doctor, Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases and Clinical Angiology
Dolgorukovskaya str., 4, Moscow, 127006;
Lobnenskaya str., 10, Moscow, 127411
A. M. Evseev
The Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Evseev Alexander Maksimovich – a doctor, postgraduate student at the Department of Faculty Surgery No. 1 of the Institute of Surgery
1 Ostrovityanova str., 117513, Moscow
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For citations:
Evseev M.A., Musailov V.A., Fomin V.S., Evseev A.M. Total gastrectomy with intestinal J-pouch: paradigms past and present. Moscow Surgical Journal. 2025;(2):55-64. (In Russ.) https://doi.org/10.17238/2072-3180-2025-2-55-64
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