Jejunum segment interposition after total proximal gastrectomy (by the 70th anniversary of the Merendino—Dillard procedure)

Objective. To evaluate safety and efficacy of jejunum segment interposition after proximal gastric resection. Material and methods. There were 80 jejunum segment interpositions after proximal gastric resection in 2012—2023. Primary subtotal proximal gastric resection was performed in 70 (87.5%) patients, resection of esophagogastrostomy in 9 (11.2%), gastric bypass surgery — in 1 (1.3%). The indications for surgery were cancer in 66 (82.5%) patients, recurrence of cancer in esophagogastrostomy — 2 (2.5%), postgastrectomy diseases — 12 (15.0%). Mean age of patients was 62 years. There were 51 (63.8%) men and 29 (36.2%) women. Results. In early postoperative period, 8 (10.0%) patients developed complications. Failure of esophagojejunostomy occurred in 5 (6.3%) cases, subdiaphragmatic abscess — in 1 (1.3%) patient. Another (1.3%) patient had jejunum insert necrosis that required its extirpation and direct esophagogastrostomy. One (1.3%) patient died from non-occlusive mesenteric ischemia with intestinal necrosis on the 3rd day after surgery. There were no long-term specific complications related to jejunum segment. Reflux esophagitis was recorded in 2 (3.6%) out of 56 patients. Conclusion. Jejunum segment interposition after proximal gastric resection is a relatively safe technique preventing severe reflux esophagitis.