Double tract reconstruction after total gastrectomy in patients with gastric cancer: our experience.

PURPOSE Gastric cancer (GC) remains one of the most frequent cancers worldwide. After total gastrectomy it is necessary to reconstruct the upper part of the digestive tract. The double tract (DT) method is the optimal reconstruction procedure aftertotal gastrectomy for patients with gastric cancer. METHODS In General Hospital "Sveti Vracevi" in Bijeljina, from January 2006 to January 2009 37 patients who underwent a total gastrectomy with a curative resection were included in the research. RESULTS In this study we observed early postoperative complications and mortality, postoperative food intake and nutritional status (hemoglobin, total proteins and albumin), and incidence of diarrhea and dumping syndrome at 1 and 3 years. Tumor diffused in the sections of stomach in 37 cases: cardia and body in 14 cases, body and antrum in 16 cases, and in only body of stomach in 7 cases. In the pathological examination, the tumors of 34 patients were diagnosed as adenocarcinoma, 2 as malignant lymphoma, and i as leiomyosarcoma. CONCLUSIONS The benefits of this method are (1) a simple procedure; (2) preservation ofthe duodenal passage; (3) no duodenal stump, resulting in no risk of postoperative stump rupture.