Journal of the American College of Surgeons
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There is very little published data concerning the knot handling properties of suture materials. The few studies that are available on this subject contain discrepancies in nomenclature, testing methods, and in the type of data reported. To date, there has been no effort to present what is currently known concerning knot security in a unified format. ⋯ Existing studies have demonstrated a strong variation in the efficiency of different surgical knots. Standards for testing and nomenclature have been presented. Effort now needs to be directed in three areas: simulating in vivo conditions, testing knots under these conditions, and determining the factors that make some suture materials more efficient in knot holding than others.
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The Roux-en-Y gastrojejunostomy is a popular method in the operative treatment of alkaline reflux gastritis and other postgastrectomy sequelae, but is associated with a high incidence of the so-called "Roux stasis syndrome." The Henley jejunal interposition has been used occasionally, albeit not widely, as an alternative to the Roux-en-Y reconstruction. ⋯ This experience suggests that the Henley jejunal interposition is our effective method of treating reflux gastritis and is not associated with the poor emptying frequently associated with the Roux-en-Y reconstruction.