Evaluation of transverse colon interposition following total gastrectomy in patients with gastric carcinoma.

In order to improve the quality of life of patients who received total gastrectomy for treatment of gastric carcinoma, transverse colon interposition (TCI) was performed on 133 patients since June, 1986. To evaluate TCI, post-operative follow-up studies were conducted. Group I patients received TCI (N=40). Group II patients received Roux en Y anastomosis (R-Y anastomosis) (N=20). These groups were compared in a five-year post-operative study. Alkaline reflux esophagitis was significantly lower among patients who received TCI compared to patients who received R-Y anastomosis (p<0. 05). There was no significant difference between groups I and II with respect to food consumption. In the period from four months to five years following surgery, the average weight loss (% body weight) was significantly lower (p<0.01) in patients who received TCI compared to patients who received R-Y anastomosis. During OGTT, group I patients had significantly higher postprandial pancreatic glucagon response than group II patients. The plasma glucose tolerance in group I was significantly better than that of group II (p<0.05). The average postprandial plasma gastrin level, 30 through 120 min following glucose loading, was significantly higher in group I (p<0.05).