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The Roux-en Y recostruction after total or subtotal gastrectomy for gastric cancer is frequently performed to prevent
esophageal alkaline reflux.
Also after total gastrectomy and end-to-side gastrojejunal anastomosis, as usual in former experience, the alkaline reflux
can be efficaciously treated by conversion in an esophago-jejunal Roux-en-Y procedure. The main factor preventing reflux
is the length of jejunal loop, at least of 35-40 cm.
The recostruction with a Roux-en-Y jejunal loop offers the advantage to meet together two primary requirements: the
restoration of digestive travel from esophagus to intestine, and the prevention of on alcaline reflux esophagitis, both with
relevant simplicity and without a time-consuming surgical technique. Also as a consequence the postoperative morbidity
is decreased. The obvious suitable requirement is a sufficient lenght of the jejunal loop for a reservoir of the ingested
food and to oppose the antiperistaltic jejunal movements thanks to the effects of the new activated jejunal pace-maker.