Radiographic study of patients submitted to total gastrectomy using safatle reconstruction technique

Abstract

Background - Ever since the first total gastrectomy, there has always been a great concern in increasing the survival of patients, and with the advance of techniques, in improving the quality of life of these patients. The most common reconstruction technique of the gastrointestinal transit is the Roux-en-Y. The reposition of a functional pouch in place of the resected stomach was proposed to minimize the postprandial symptoms, improve the nutritional grade and consequently, the quality of life. The Safatle reconstruction of the gastrointestinal transit technique consists of, in short, in the association of the interposition of the jejunal loop with partial transit through the duodenum, with an inverted Roux-en-Y and with the creation of a pouch which resembles the dynamics of the stomach, achieved by duodenojejunal segment which has an antiperistalsis emptying. Aim - To assess, by radiographic means, the emptying of the duodenojejunal pouch in patients submitted to total gastrectomy using the Safatle reconstruction technique. Method - Twelve patients submitted to total gastrectomy using the Safatle technique due to gastric cancer were studied. They were summoned to perform contrasted radiographies of the esophagus-duodenum- jejunum by the videofluoroscopic method during the months of July and August, 2005. Results - All the patients presented satisfactory movement of the duodenojejunal pouch and an adequate emptying in antiperistalsis without food stasis. There has been an average 25-minute drainage time of the duodenojejunal pouch. Conclusion - The duodenojejunal pouch, in the patients submitted to total gastrectomy using the Safatle reconstruction, presented adequate emptying and movement.