E. Strong (ed.). Gastric cancer. Principles and practice. Springer (2015)

Removal of parts or the whole stomach due to stomach cancer or benign diseases is normally followed by the reconstruction of the digestive tract continuity (Fig. 12.1) [1]. Several different approaches have been described to achieve this goal [2–9]. Decisive factors that have to be taken into account when deciding on the type of reconstruction include functional outcome, the morbidity rate of the procedure, and the lifetime expectancy of the patient. The functional outcome includes the possible postoperative diet and resulting nutritional status of the patient and his quality of life. The morbidity rate as well as the associated mortality rate depends on the complexity of the procedure, i.e., the formation of a pouch or the inclusion of a duodenal anastomosis. The life-time expectancy needs to be balanced with the morbidity rate, favoring a rather simple reconstruction for patients presenting with advanced diseases. The availability of randomized controlled trials (RCTs) evaluating different aspects of the competing reconstruction techniques enables shared decision making, taking into account the individual case and evidence-based surgery.

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