Patients underwent an emergency jejunostomy for nutritional support until definitive treatment was performed. Of the six patients who presented late, five needed parenteral nutrition to correct their hydroelectrolytic and protein disorders:
this was continued until definitive treatment of their gastric stricture for three patients and until a jejunostomy was performed 10 days later in the two other patients.
The sixth patient died seven days after admission of acute anemia, dehydration and malnutrition. Neither adequate parenteral nutrition nor jejunostomy were possible in this patient.
Definitive surgical treatment was performed for the seven surviving patients on Day 85 (74 to 123). The patients with microgastria had a total gastrectomy with Roux-en-Y
esophagojejunostomy (n = 2) (Fig. 4), those with midgastric stricture (n = 1), corporeoantral stricture (n = 1) underwent distal gastrectomy with gastrojejunostomy (n = 2), while those who had an antropyloric stricture underwent simple gastrojejunostomy without resection (n = 3). Mean duration of hospital stay was 13 (11 to 17) days. Postoperative morbidity consisted of one digestive fistula treated medically.
Postoperative mortality was nil. Mean follow-up was 4 years (1 to 7) during which time none of the patients had any swallowing disorder (dysphagia) suggestive of esophageal stricture.
There were no new suicidal attempts. All patients regained weight postoperatively