rho-Shaped anastomosis: a reconstruction of the alimentary tract after total gastrectomy.

One hundred sixty-four patients underwent total gastrectomy with a rho-shaped jejunal food pouch (rho loop) and roux-en-Y jejunojejunostomy. The rate of postoperative complications was very low (9.1 per cent), and the most important problem of anastomotic failure was never encountered. Only 4 of 164 patients (2.4 per cent) died within one month of surgery, and the causes of death were pneumonia (2 patients), cerebral hemorrhage (1), and ileus (1). The function of the newly constructed passage was estimated through an elaborate barium meal examination. The test revealed that the rho-shaped jejunal food pouch has adequate reservoir and mixing functions for ingested foodstuff. No reflux of barium meal into the esophagus was observed during the examination. In a follow-up study of the patients, only a few complained of symptoms of reflux esophagitis or dumping, but none of them needed any treatment.