Interpositional jejunal or Rouex en Y ?

[medway]

I'm due to have the op in 2 weeks. I'm lucky as I only have very early cancer of the lower Oesophagus and upper stomach. I have been offered 2 possible ops. A length of jejunal from the oesophagus to half my stomach or the full Roeux en Y, all stomach out with the 'Y' (bile & acid introduced lower down the digestive tract).

I'm ver fit and very active and want to remain so, so my question is has anybody had one of these and totally recovered physically? I sail, hillwalk and do car and house repairs, dig the garden etc.

I'm told Rouex en Y will give no reflux and interpositional less than a pull up.Comments?

[Hidden]

I was wondering how you had been getting on!

The good thing is that you know about it when it is in the very early stages.

I suppose the questions are: a) which one is a better prospect for treating the cancer?.

b) is there likely to be a difference in your physical strength prognosis and stamina between the two operations?, and

c) does one give less acid / bile reflux than the other?

They are both serious operations that will take a long time to get over properly.

The surgeon may have some specific advice about this choice.

[medway]

My surgeon has suggested the interposition as there is a quicker recovery and better digestion and hence more chance of a return to before, but I was hoping for confirmation of this before deciding. He says there is little risk of cancer being lower in the stomach.

A review on a website from a poll suggested little difference!

I've also being trying to establish if radiation is an option for T1 or less but just cannot get anybody to answer this question. Halo ablation is certainly a successful treatment for Barretts of the Oesophagus but not the stomach, at least in the UK.

[fredsonic]

I have had the Roux en Y & there is no acid reflux as the whole stomach is gone in my case. I would say having a bit of stomach left will help as you have some storage space for food. My whole stomach has been taken out & now I have to eat tiny portions of food regularly. Like you I was a keen DIYer, did hill walking & cycling. I am regaining fitness, but it is a slow process. I have joined the gym - start tomorrow. Been doing regular walks of a few miles per day. Went for my first bike ride on Friday, did about 3 1/2 miles. I am only five weeks post op so it is a start. I tire very quickly though & can't cope well with hills yet. Still need a nap in the afternoon. Not allowed to lift anything at this stage so can't do much round the house. Been warned by the nurse to expect nine months off work. It is a big op & the recovery is a long road. Good luck with whatever you choose.

[medway]

I was thinking about the Roux en Y as there is no reflux but after saying I wanted less reaction he suggested the interposition but if the effects are the same then I might as well go for the Roux en Y. Maybe because there will be some stomach, food intake & nutrition retention will be better.

I hope somebody can comment on interposition with some stomach.

[medway]

I'm now 2 weeks after the op. This is just to answer any questions regarding what to do if you have just a T1 cancer of the stomach and I know that many on here are far worse off than me. I was very lucky that after having prostate cancer they did a body scan and found I had the stomach 'calcification' meaning not sure but we will do an endoscopy.

I had T1?? of the top of the stomach and had to make a decision to either have all or just the top of my stomach removed. I went for just what was necessary with a 10cm jejunal interposition between the remaining oesophagus and remaining stomach . I have just seen the surgeon who has given me the all clear with just T1B in the small area they new of. The B indicates cancer has gone to the 2nd stomach layer so the op was necessary.

Although its early stages yet, everything has gone well and I have started eating ok although I'm still loosing some weight. I'm told 6 weeks before I can do anything manual. No reflux - so far, but time will tell.

Which of the ops one chooses is difficult. I was lucky (very) and the cancer had not gone anywhere else as far as the surgeon can see after lots of tests. If they had found further cancer on the edges of the removed 'bits' then another op would have been necessary.

I had 5cm of Oesophagus removed as it had barretts so this had to come out. Now they have to watch for Barretts/reflux but if this appears HALO ABLATION IS AN OPTION. As far as I'm aware its only available at frimley park hospital Surrey and Glasgow.

Hope this all helps sombebody before they make their decision.