Oesophageal Patients Association
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Merendino interposition - one year after

This is a fairly rare op if you have T1 cancer and briefly has a length of jejunum added between the remaining stomach and oesophagus with the intention of stopping reflux. I am informed they only do this op if you have early or T1 cancer as with more serious cancers they have to remove more tissue. No radiation treatment is give before or after the op. You have to be fit to undergo this major surgery.

One year after the op, I am fit and well and nearly back to normal except for some digestive problems. My surgery to perform this op has left a scar about 300mm across my midrift (to get full access for a complicated bit of 'plumbing') which is tight and slightly discomforting.

I have no reflux at all as the jejunum is a soft normally flattened tube which only opens when you eat. Sometimes it takes a minute or two before I can continue eating after a few mouthfulls of food while the jejunum is opening up.

Occasionally I still feel ill for an hour or two if i overdo the eating. Chocolate, apples and anything that increases wind can start me off. As the attacks are rare, you think you are back to normal but find you are not. Why you feel ill I do not understand but the cause is just too much wind which the jejunum seems to stop coming up until the pressure is high, then repeated burping.

Overall the addition of a length of jejunum, 10cm in my case, definitely stops reflux and i sometimes wonder if it is too efficient.

Sadly this op is not available to most people on here but hopefully my comments will be welcomed by people who have been offered this option. I understand that complications can occur and has high potential risks of problems post op compared with the pull up, but in my case I have been lucky.

Next time I see my specialist I will ask him why jejunum cannot be inserted when the full pull up op is done. Perhaps because the surgery is complex and many people are not well enough.

These are my comments and I hasten to add that you should take the advise of your surgeon.

3 Replies

Glad you are doing so well. A lot has happened in the last twelve months for you!

I wonder if it is colic that you are experiencing - like babies that cannot get rid of the wind?


You could be right Alan. I think the jejunum implant is too successful in stopping reflux but I'm well pleased with no reflux. I'll discuss with my surgeon next time I see him in December and see what he suggests.

p.s. not in Medway anymore. We have moved outside the southeast. Thanks for your support. Hope my comments may be useful to somebody some time. Very little info on this op from 'sufferers'.


Hi medway. I am looking at the same procedure but for different reasons. I have had multiple reflux ops which have all failed and my consultant suggested this. Can I ask a few details.

Were your vagal nerves cut or preserved.

Did you have a drainage procedure like a pyloroplasty.

Also. My consultant has no experience of this op so would be good to know who did your's .

I think you made a wise choice and hope all is going well.


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