Application of jejunum with vascular pedicle in reconstruction of the digestive tract.

Objective: To reconstruct the digestive tract using the jejunum with vascular pedicle after esophagectomy or gastrectomy, and observe the therapeutic effects and the patients' quality of life after the operation.

Methods: This study included a total of 25 patients, 10 of whom received proximal subtotal gastrectomy followed by reconstruction of the digestive tract with P-shaped jejunum for anastomosis of the esophagus and the residual stomach, 15 had total gastrectomy and anastomosis of the P-shaped jejunum with the esophagus inferior to the arch of aorta, with another 2 having total gastrectomy and the anastomosis superior to the arch of aorta. The pH value of the esophagus was tested, barium meal and gastroscopy were carried out 3 months after the operations, and the patients' quality of life assessed.

Results: Anastomotic leakage or infections in the thoracic or abdominal cavity occurred in none of the patients. All the patients had no postoperative difficulty in eating cooked rice, and were free of reflux esophagitis and burning sensation in the chest. The pH value of the esophagus was 5.5-6.6. Eight patients survived for more than 5 years.

Conclusions: The effects of digestive tract reconstruction using the jejunum with vascular pedicle after esophagectomy or gastrectomy are satisfactory, especially in patients with esophageal cancer in the lower section or cardia cancer. This operation gives rise to low rate of operative complications, and insures good quality of life of the patients.