Total gastrectomy with intestinal j-pouch paradigms past and present

Introduction. A comparative analysis of the immediate and long-term results of various reconstruction options for gastrectomy according to Ru allowed us to present the intestinal reservoir as a functional element of the digestive tube with a pronounced protective function, contributing to a more effective adaptation of digestive processes after surgical removal of the stomach. Research materials and methods. To determine the characteristic features of the postoperative course, the immediate and functional results of gastrectomy with the formation of a proximal intestinal reservoir on the Ru loop, a retro- and prospective comparative multiparametric cohort analysis of the course of the immediate and long-term postoperative period was performed in 133 patients (average age 63.3±6.1 years) who underwent gastrectomy with a general scheme of reconstruction according to Ru and various variants esophago-enterostomy, for the period from 2019 to 2024. Results. The formation of a proximal intestinal reservoir on the loop with invagination transverse esophago-enteroanastomosis was accompanied by a minimal number of intra- and extra-abdominal complications, no deaths, early recovery of the motor evacuation function of the digestive tube, a minimal number of patients with postoperative reflux esophagitis and a significantly higher quality of life. Conclusion. The presented functional results of using the technique of forming a proximal intestinal reservoir on a loop with invagination transverse esophago-enteroanastomosis make it possible to consider the use of this surgical technique in a modern surgical clinic as legitimate and appropriate.