The Roux-en-Y concept in the surgery of malignant tumors of the gastropancreatoduodenal region. Experience and results

Objective. Currently, Roux-en-Y reconstruction is a standard surgical technique, and in some cases - the method of choice, for distal resection of the stomach and gastrectomy, for repeated operations on the upper section of the digestive tube and the formation of bilio-digestive anastomoses, for various options for resection of the pancreas, in practice metabolic / bariatric surgery. The aim of this study was to demonstrate the possibilities of using Roux-en-Y reconstruction in surgery of malignant neoplasms of the gastropancreatoduodenal region.Material and methods. The authors presented the experience of using the Roux-en-Y principle in oncosurgery of the gastropancreatoduodenal zone during distal gastric resections, total gastrectomies and gastropancreatoduodenal resections. A comparative analysis of the immediate and long-term functional results of 267 surgical interventions with Ru-style reconstruction and 79 operations performed with other reconstruction options was carried out.Results. A fundamentally better patient tolerance of Roux-en-Y reconstruction was established according to the criteria of the course of the immediate postoperative period (intraoperative complications 12.8% vs 44.3%, the number of relaparotomies 3.4 vs 20.4%, postoperative mortality 4.5 vs 11, 3%), as well as the best functional results of Roux-en-Y reconstruction in relation to the occurrence of impaired gastric evacuation, gastric and esophageal reflux in the near and long term.Conclusion. The experience and results of applying the Roux-en-Y concept, demonstrated in this study, are another confirmation of the unique properties of this reconstruction option - pathogenetic validity, technical reproducibility, predictability of immediate and long-term results - and the related demand for Roux-en-Y reconstruction in abdominal surgery.