胃癌全胃切除术后消化道重建方式的选择  

Digestive tract reconstruction after total gastrectomy for gastric cancer

作　　者：伍韶斌[1] 陈志康[1] 陈晋湘[1] 廖国庆[1] 晏仲舒[1] 欧阳植庭[1] 裴海平[1] 陈子华[1] 

机构地区：[1]中南大学湘雅医院普通外科,湖南长沙410008

出　　处：《中国普通外科杂志》2006年第10期766-768,共3页China Journal of General Surgery

摘　　要：目的探讨全胃切除术后较理想的消化道重建方式。方法对近6年来1 2 2例施行全胃切除术患者的临床资料进行回顾性分析。全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。结果3种术式在食后烧灼感、进食量、进食次数、体重下降、倾倒综合征、血红蛋白、白蛋白等指标的比较,无明显差异(均P>0.0 5)。P型空肠袢食管空肠Roux-en-Y吻合术组所用手术时间显著多于Orr组及反口组(P<0.0 5)。反口组的贮袋大小及半排空时间显著优于Orr组及P袢组(P<0.0 5)。结论远端空肠反口贮袋的Roux-en-Y吻合术是一种值得推荐的新型全胃切除术后消化道重建方法。Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy. Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were analyzed retrospectively. Three types of reconstruction procedures, including Orr- type Roux - en- Y esophagojejunostomy, P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy, were performed. Results There were no significant differences among the three procedures in heartburn and the amount of food intake, frequencies of meal, weight loss, dumping syndrome, and hemoglobin and albumin levels. The operation time in P-type group was longer than the other two group （ P 〈 0. 05 ）. The size of pouch and pouch emptying function in aboral pouch group were significantly superior to the other groups. Conclusions Distal jejunal aboral pouch Roux- en- Y esophagojejunostomy can he recommended as a new procedure for digestive reconstruction after total gastrectomy.

关 键 词：胃肿瘤/外科学 全胃切除术 消化道重建术 

分 类 号：R735.2[医药卫生—肿瘤]