Robot-assisted total remnant gastrectomy for interposed jejunal pouch dysfunction 25 years after proximal gastrectomy for gastric cancer: A case report.

Journal: Asian journal of endoscopic surgery
Published Date: May 23, 2023

Abstract

Proximal gastrectomy (PG) in combination with jejunal pouch interposition is a technique aimed at improving the postoperative dietary outcomes; however, some cases are reported to require surgical intervention owing to difficulty of food intake caused by pouch dysfunction. Herein, we present a case of robot-assisted surgery for interposed jejunal pouch (IJP) dysfunction in a 79-year-old male, occurring 25 years after the initial PG for gastric cancer. The patient had chronic anorexia for 2 years and was treated with medications and dietary guidance; however, 3 months prior to admission his quality of life had reduced, owing to worsening symptoms. The patient was diagnosed with pouch dysfunction due to extremely dilated IJP identified using computed tomography and underwent robot-assisted total remnant gastrectomy (RATRG) with IJP resection. After an uneventful course of intraoperative and postoperative treatment, he was discharged with sufficient food intake on postoperative day 9. RATRG can, thus, be considered in patients with IJP dysfunction after PG.

Authors

  • Sunao Uemura
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Hiromichi Yamai
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Kazuhisa Onishi
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Fumio Chikamori
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Mitsuteru Yoshida
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Norihiro Hokimoto
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Hisashi Matsuoka
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Jun Iwabu
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Koji Ueta
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Ryo Yamada
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Kai Mizobuchi
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Akira Marui
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.
  • Nobuyuki Tanida
    Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan.

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