Novel reconstruction using pedicled ileocolic interposition after laparoscopic total gastrectomy: A report of two cases

Introduction: Although Roux-en-Y reconstruction using the jejunum is generally performed after laparoscopic total gastrectomy, the postoperative function is inadequate. We designed a novel reconstruction technique using pedicled ileocolic interposition with laparoscopic anastomosis of the esophagus and ileum, and further anastomosis of the colon and duodenum. Two patients were treated with this technique.

Case presentation: Case 1 involved a 74-year-old man with multiple gastric cancer. Case 2 involved a 77-year-old man with extensive scirrhous esophagogastric junction cancer and esophageal invasion of 2 cm. These 2 patients underwent laparoscopic total gastrectomy and pedicled ileocolic interposition anastomosis. The patients were discharged without major complications.

Discussion: We anticipate that the implementation of this reconstruction method will enhance the quality of life of patients after total gastrectomy, particularly in terms of minimizing esophageal reflux and facilitating oral ingestion. To our knowledge, this is the first report of laparoscopic reconstruction with a pedicled ileocolic interposition after total gastrectomy.

Conclusion: Pedicled ileocolic interposition is characterized by the expectation of good postoperative function owing to the anti-reflux mechanism of the ileocecal valve and adequate reservoir function of the cecum and colon.