Restore the continuity of the digestive tract

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After resection of the distal portion of the stomach restore the continuity of the digestive tract now produce two ways. Connect the stump of the stomach or directly with the stump of the duodenum, or with the beginning of the jejunum.
The first successful resection of the distal gastric cancer was produced by Billroth [Billroth So, 1881]. Before these operations, but without success, were executed by Peano [Pean J., 1879] and Ridiger [Rydygier L., 1880].
After removal of the tumour distal stomach, Billroth restored the continuity of the digestive tract, combining the stump of a stomach and a duodenal gut anastomosis end-to-end. This method was called "the first way of Billroth" (method B-I). Subsequently, there were numerous modifications to it, no special differences,when they remain the basic principle of the way the B-I, that is, the flow of food from the stump of the stomach to the duodenum.
In 1885 Billroth offered his second method (method B-P), which is that after resection of the distal portion of the stomach his stump and the stump of the duodenum are closed with stitches tightly, and the continuity of the digestive tract is restored by imposing anastomosis between the stump of the stomach and the initial division of the jejunum. During this surgery, the food from the stomach, bypassing the duodenum, enters directly into the skinny.
Currently apply various modifications of this method, of which the most widespread are the following: 1) the Method Reichel-Pole [Reichel F., 1908; Polya that is, 1911]. In this way sutured only the stump of duodenal ulcer and gastric stump not sutured and the full width of its lumen anastomoses with the beginning of the jejunum, carried out through the hole in the large intestine mesentery. 2) The Way Ru [J. Roux, 1893]. If this way of duodenal stump closed tightly, and the stump of the stomach anastomosed with abducting end cross jejunum resulting end-figuratively connects coustem with abducting end ulcers on 15-20 cm lower gastrointestinal fistula. 3) Fashion Balfour (D. Balfour, 1917) - the gastro-intestinal anastomosis impose on a long loop jejunum, adding inter-intestinal fistula. 4) Method of the Comptroller - Finsterer or Spasokukotskogo - Finsterer, or Spasokukotskogo - Villmsa (Hofmeister M, 1896; Finsterer N., 1914; Wilms M, 1911). This technique is used most often. It differs by the fact that after resection of the distal portion of the stomach and closing tightly duodenal stump, the stump of the stomach is closed only partly by small curvature and anastomotic short loop jejunum, carried out through the hole in the mesentery transverse colon. Leading to anastomosis part of the intestine is attached to the stump of the stomach from small curvature. Thus enhance the least strong position of seams anastomosis,- at the junction of them with seams stump, and besides, this creates a kind of valve, preventing from entering the contents of the stomach into the duodenum.
When choosing a method of resection of stomach cancer is first necessary to consider the fact that cancer is usually older and often very weak people who can't handle complicated surgery. We have said that, despite the great success of modern surgery, direct mortality, even after the usual gastrectomy, these patients is very high. In addition, operation efficacy is often insufficient, and therefore many of those patients who survived the operation, soon die from disease recurrence.