Merendino jejunal interposition for T1 only cancer. What is it? A report back. This may help you to make a decision before an op.

[medway]

I had this op 2 months ago and as its a fairly rare op and as my surgeon said 'adventurous', I was asked to keep the OPA informed......this is for early cancer only. I hope yours is.

I was lucky they found T1 at the oesophagal and stomach junction & barretts but had to have it removed. The option was full Roux en Y or partial oesophagus and stomach only with a 10cm jejunum section from lower down between them (interposition) to stop reflux. I chose the later. After the op i was informed it was T1B - gone into the second layer of the stomach. I was informed they definitely had got it all. No cancer on the edges of the bits taken out. I'm lucky, very.

Firstly be very fit before the op. I am and came out after 7 days. Fitness is very important before an op. Get walking!

After effects? No pain luckily except 3 times a few weeks later when I started to eat normally. It has now stopped and I think it was associated to constipation as it was wind but very painful in the stomach. I get a lot of wind! I get occasional periods after eating when I feel very ill. Its not known why but i think it is over eating as i still have most of my stomach and its easy to think my digestion is ok. Its not. I'm told my digestion will improve with time. My surgeon thinks the pain may have been wind pushing bile back into the stomach.

Because the op is to the junction, and removal of jejunum from lower down for the interposition the scar is massive from one side to the other. Infection is normal when using jejunum as its in the 'dirty' part of the system. Mine was held by drugs. I have a small hole still after 2 months as some small infection is still trying to get out. Expected to be healed soon. I have no reflux. I lost 1.5 stone in weight.

An endoscopic check on January 17th so I hope to have a full ok............

[Hidden]

Thanks very much for this - and we will all hope that you continue on the road to a full recovery.

Bet you never knew all those medical terms a few months ago!

Best Wishes

Alan

[medway]

Absolutely correct Alan. Who knows anything about cancer before they get it. Would rather not have had it though! I'm lucky in the surgeon not rushing me into a decision and i did a lot of investigating. What swung the merendino interposition, although being described as 'adventurous' whatever that means is that there is a report on the internet of I think it was about 28 feedbacks, only 2 had any reflux and the long term prognosis after recovery was fairly normal eating and longevity.

i still feel quite ill after eating sometimes and i think it is over eating. As I have most of my stomach, I think I can eat well but the body thinks otherwise. I dont really understand how I can develop so much wind so rapidly and why it makes me feel ill. My followup doctor (not the surgeon) has suggested I have Alkaline reflux which is bile perhaps being pushed back into the stomach but I get no reflux because of the jejunum. Perhaps when I eat too much the brain says lots of bile to be made?? Roux en Y diverts the bile lower down so perhaps this could be done with Merendino? I'll ask the surgeon if this was an option.

[Westoncromwell in reply to medway]

I had my operation on 3/10/11 total gastroectomy, and then a 6 week rest and now in week 6 of 9 of chemo 'just in case' stage.

With regard to diet, I have a good appetite and only come unstuck if I over eat especially with chocolate or fruit. I find Rennies really help if I have overdone it. Dumping doesn't occur unless I have really abused eating but I find 1 Imodium or similar does the trick quite adequately.

I can eat most things but try and discipline myself to eating more slowly, not too much in one session and to chew a bit more.

With regard to scars I had keyhole surgery and the scar was 3 to 4 inches.

Kind regards

Brian

[medway]

Had a barium meal a couple of weeks ago. Saw the result and saw that rather than having just a straight piece of jejunum (intestine)from the oesophagus to the remains of my stomach there was a lot more, probably double the length and looked like a piece of coiled spring turning round.

Just had a endoscopic examination to check if all is well and the endoscope could not get into the stomach to check it down there because of the coiled up jejunum! Waiting to hear what my surgeon says. He aint opening me up to have a look!