Double-Tract-Rekonstruktion nach Resektion des gastroösophagealen Übergangs wegen AEG-II- und -III-Tumoren

Zusammenfassung

Bei selektionierten AEG-Typ-II- und -III-Tumoren (AEG = Adenokarzinome des ösophagogastralen Übergangs) der T-Kategorien 1 und 2 kann der distawle Magen nach proximaler Resektion ohne Beeinträchtigung der Radikalität und der Prognose erhalten werden. Als Rekonstruktion wird die Doppeltraktanlage mit Seit-zu-Seit-Anastomosierung des distalen Magens in die Roux-Y-Jejunumschlinge nach Ösophagojejunostomie dargestellt. Nach der Literatur hat dieses Verfahren eine niedrige Rate von postoperativer Refluxösophagitis, erfordert gegenüber der totalen Gastrektomie signifikant geringere Dosen an Vitamin-B12-Substitution und die Hämoglobinwerte sind signifikant höher.

Abstract

In selected adenocarcinomas of the oesophagogastric junction with AEG types II and III and of T-category 1 and 2, proximal gastric resection with preservation of the distal stomach can be performed without impairment of radicality or prognosis. Double tract reconstruction with side to side anastomosis of the distal stomach to the Roux-en-Y jejunal loop after oesophagojejunostomy is presented. According to the literature, this procedure has a low rate of postoperative reflux oesophagitis and long term effects include significantly lower dosage of vitamin B12 substitution and significantly higher haemoglobin levels than after total gastrectomy.

Schlüsselwörter

Magenkarzinom - Adenokarzinome des ösophagogastralen Übergangs - proximale Magenresektion - Double-Tract-Rekonstruktion - Vitamin B12

Key words

gastric cancer - adenocarcinoma of the esophagogastric junction - proximal gastrectomy - double tract reconstruction - vitamin B12

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