Anatomical classification of the shape and topography of the operated stomach

Abstract

The aim of the study was to present the classification of anatomical variances of the operated stomach, based on the radiological and historical data. Different anatomical variations of the operated organ were revealed in 431 out of 2034 patients examined in years 2006-2010. Four primary groups were established: abnormal position along longitudinal (I) and horizontal axis (II), as well as abnormal shape (III) and stomach connections (IV). An additional group (V) encloses mixed forms that connect features of two or more primary groups. The first group contains the partial and total translocation of the stomach into the thoracic cavity after the partial or total esophagectomy. Depends on the applied surgical techniques used during the total esophagectomy, the stomach could be located in the front or back to the pericardial sac. An elongated and gestrectatical form often with signs of pylorostenosis is visible in patients treated by the vagotomy. The consequences of fundoplication included: lack or narrow cardiac angle, and often mild form of the stomach cascade. The most common abnormal shape of the stomach was secondary to the gastrectomy and gastric bending. The final organ shape depends on the type of applied surgical procedure that maintains physiological connection with the duodenum or un-anatomical one, mostly with the jejunal loop. In banding, the body of the stomach forms hourglass on the level of the artificial adjustable band, typically fitted for the surgical slim purpose.