Reconstructive surgery for dumping: an assessment of the effectiveness of different surgical procedures by use of a physiological test meal.

Resumo

The present paper reports the results of a clinical trial designed to assess the efficacy in eliminating dumping syndrome of isoperistaltic jejunal interposition, versus Lawrence technique of revisional surgery, versus Lygidakis method by use of a physiological test meal. Two out of five patients who underwent revisional surgery by isoperistaltic jejunal interposition were cured, the remaining three being left with their pre-revisional symptoms unaltered. Three out of five patients with a Lawrence type of reconstruction were improved but were complaining of newly-presented post-cibal symptoms of fullness and regurgitation. The remaining two were re-operated because of incapacitating post-revisional symptoms due to pronounced pouch retention and underwent further surgery by the new method with satisfactory results. All five patients who underwent a Lygidakis type of reconstruction were cured and remained free of symptoms from a period of 1 to 7 years. The Lygidakis technique has been proved from the results of this study to be simple in performance, safe in terms of mortality and morbidity and satisfactory in both short and longterm results. It seems therefore reasonable to recommend this procedure for the surgical treatment of dumping syndrome.