近端胃癌术后重建方式与术后反流发生的关系探讨  

Study on the Relationship between Postoperative Reconstruction of Proximal Gastric Cancer and Reflux Occurrence

作　　者：马二民[1] 王洁实 花亚伟[2] 

机构地区：[1]河南省平顶山市第一人民医院胃肠外科,河南平顶山467000 [2]河南省肿瘤医院普外科,河南郑州450003

出　　处：《临床医学工程》2011年第6期902-903,共2页Clinical Medicine & Engineering

摘　　要：目的通过对近端胃癌术后五种重建方式与反流发生的临床资料进行回顾性分析,探讨全胃切除术后更加符合生理的消化道重建方式。方法选择2007年1月～2009年1月平顶山市第一人民医院胃肠外科行全胃切除术的患者46例,近端胃癌根治术20例,分别采用功能性间置空肠代胃术,间置空肠代胃,P型间置空肠代胃术,Roux-en-Y吻合术式,食管残胃后壁吻合,随访其发生反流性食管炎的比例与严重程度。结果返流性食管炎发生率分别为12.5%,0.0%,25.0%,68.2%,和86.7%;其中行食管残胃吻合术式的4例发生严重的反流,营养不良,生活质量极差。结论功能性间置空肠代胃术和间置空肠代胃对于减少近端胃癌术后反流、提高生存质量有重要意义,是近端胃癌根治术后理想的重建术式。Objective Through the retrospective analysis of clinical data of five kinds of postoperative reconstruction of proximal gastric cancer and reflux occurrence,to explore the digestive tract reconstruction more in line with the physiology after total gastrectomy. Methods 46 patients with total gastrectomy and 20 patients with proximal gastric cancer surgery who were selected in gastrointestinal surgery of Pingdingshan First People＇s Hospital from January 2007 ～ January 2009 were treated by functional reset jejunum generation stomach operation,reset jejunum generation stomach operation,P-type reset jejunum generation stomach operation,Roux-en-Y anastomosis operation type,anastomosis of posterior wall of esophagus residual stomach,the proportion and the severity of occurrence of reflux esophagitis were followed. Results The incidence of reflux esophagitis was 12.5%,0.0%,25.0%,68.2% and 86.7%;severe reflux and malnutrition of 4 cases of residual stomach esophagus anastomosis occurred,their quality of life was poor. Conclusions Functional reset jejunum generation stomach operation and reset jejunum generation stomach operation have important significance in reducing postoperative reflux of proximal gastric cancer and improving quality of life,which are the ideal postoperative reconstruction of proximal gastric cancer.

关 键 词：近端胃癌 重建方式 功能性间置空肠代胃术 间置空肠代胃术 

分 类 号：R735.2[医药卫生—肿瘤]