胃癌全胃切除42例临床分析  

Clinical analysis of 42 cases of total gastrectomy for gastric cancer

作　　者：李鹏程[1] 崔杰[1] 张世和[1] 

机构地区：[1]安徽省马钢集团控股有限公司医院普外科,马鞍山243000

出　　处：《腹部外科》2004年第5期278-279,共2页Journal of Abdominal Surgery

摘　　要：目的 分析和总结胃癌全胃切除术和术后并发症的治疗经验。方法 对1998～2002年在我院收治的42例胃癌的全胃切除术、合并联合脏器切除的适应证、手术入路、淋巴结的清扫、消化道重建方式、术后并发症作回顾性总结分析。结果 全胃切除术36例,合并联合脏器切除术6例。Lahey氏食管空肠吻合术12例,食管空肠Roux-en-Y吻合术29例,食管ρ型空肠袋Roux-en-Y吻合术1例。42例均经腹入路。术后并发症:肺部感染1例,胸腔积液1例,返流性食管炎2例,吻合口瘘1例,低血糖综合征1例。结论 合理掌握全胃切除术及联合脏器切除术的适应证,选择合适的消化道重建方式,提高手术操作技巧,是减少术后并发症的关键。Objective To analyze and sum up total gastrectomy of gastric cancer and postoperative complication. Methods From 1998 to 2002, 42 cases of gastric cancer underwent total gastrectomy in our hospital. The indication of total gastrectomy and that of combined organs resection for gastric cancer, operative incision, dissection of lymph nodes, methods of reconstruction of digestive tract, postoperative complication were analyzed retrospectively. Results Of the 42 patients, 36 cases (85.7%) underwent total gastrectomy, 6 (14.3%) cases underwent combined organs resection; 12 (28.6%) cases were subjected to Lahey esophagoje junostomy, 29 (69%) to Roux-en-Y esophagojejunostomy, 1 case to esophagus ρ-type jejunal pouch Roux-en-Y anastomosis. All of 42 cases had abdominal incision. The morbidity of postoperative complication: pneumonia (1 case), pleural effusion (1 case), biliary reflux esophagitis (2 cases), anastomosing fistula (1 case), hypoglycemic syndrome (1 case). Conclusion It is important to reasonably hold the indication of total gastrectomy and that of combined organs resection. To choose appropriate methods of reconstruction of digestive tract is of critical importance in decreasing postoperative complications.

关 键 词：胃癌 全胃切除术 术后并发症 食管 ROUX-EN-Y吻合术 联合脏器切除术 消化道重建 空肠 适应证 回顾性 

分 类 号：R735.2[医药卫生—肿瘤] R656[医药卫生—临床医学]