胃癌全胃切除术几种消化道重建方式的比较  

The Comparison of Several Procedures of Digestive Tract Reconstruction in Total Gastrectomy for Gastric Carcinoma

作　　者：陈斌[1] 王梦龙[1] 

机构地区：[1]江西医学院第二附属医院普外科,江西南昌330006

出　　处：《江西医学院学报》2005年第4期91-93,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的探讨胃癌患者全胃切除术后较理想的消化道重建方式。方法对115例胃癌行全胃切除术患者的临床资料进行回顾性分析。结果行食管-十二指肠端端吻合术15例(13.04%)。行食管-空肠端侧吻合、空肠-空肠侧侧吻合术40例(34.79%)。行P型空肠袢代胃术、空肠-空肠行Roux-en-Y吻合术式45例(39.13%)。行间置P型空肠袢代胃术15例(13.04%)。P型空肠袢代胃术和间置P型空肠袢代胃术式出现返流性食管炎及恶心、呕吐、腹胀者明显少于十二指肠-食管端端吻合术式及食管-空肠端侧吻合、空肠-空肠侧侧吻合术式。食管-空肠端侧吻合、空肠-空肠侧侧吻合术式有1例术后出现肠漏。采用P型空肠袢代胃术、空肠-空肠行Roux-en-Y吻合术式联合脾切除有1例术后出现脾窝感染。结论P型空肠袢代胃术手术操作简便,符合生理要求,术后并发症少,是全胃切除术后一种较为合理的消化道重建方式。Objective To explore the optimal procedure of digestive tract reconstruction in total gastrectomy for gastric carcinoma. Methods All 115 patients with gastric carcinoma underwent four types of reconstruction procedures in total gastrectomy. Their clinical data were retrospectively analyzed. Results Fifteen patients （13.04%） were operated on with duodenum-jesophagostomy. Fourty patients （34. 79%）were operated on with jejuno-esophagostomy and Brone jejuno-jejunostomy. Fourty-five patients（39.13%） were operated on with P-shaped jejuno-esophagostomy and Roux-y jejuno-jejunostomy. Fifteen patients（13.04%） were operated on with jejunal interposition with a F-shaped pouch. Two patients showed an anastomotic leakage,cellac infection after total gastrectomy in jejuno-esophagostomy and Braun jejuno-jejunostomy , duodenumjesophagostomy. One patient was found splenetic nest infection after total gastrectomy in P- shaped jejuno-esophagostomy and Roux-y jejuno-jejunostomy associated with llenectomy. Conclusion P-shaped jejuno-esophagostomy and Roux-y jejuno-jejunostomy may be one of the reasona- ble reconstructive procedures,because its operation procedure is simple, convenient, and meet to physiological need. And postoperative complication is few.

关 键 词：胃肿瘤 胃切除术 消化道重建 

分 类 号：R735.2[医药卫生—肿瘤]