简述胃癌根治术后常见消化道重建方式及评价  

Brief Description and Assessment of Digestive Tract Reconstruction Methods After Radical Operation of Gastric Cancer

作　　者：韩毓[1] 曲兴龙[1] 

机构地区：[1]复旦大学附属肿瘤医院闵行分院肿瘤外科,上海200240

出　　处：《中国继续医学教育》2016年第9期125-127,共3页China Continuing Medical Education

摘　　要：胃癌根治术后重建术的临床应用率较高,而本类手术患者术后消化道重建的相关研究也较多,且研究涉及的重建种类较多,有研究显示其多达70余种,针对各种重建术的利弊临床争议一直较大。临床对于消化道重建的要求不断提升,对于其要求主要注重于以下几个方面:(1)并发症发生率低;(2)操作简单;(3)易于推广;(4)患者有满意的营养状态;(5)良好的生存质量;(6)便于术后胃镜、X线钡餐复查等。远端胃大部切除术后,改良BillrothⅡ式及非间断性BillrothⅡ式等因并发症较少的优势,是目前重建的主流。BillrothⅠ式吻合重建则受临床应用范围的影响,其应用也受到较大程度的限制。而进展期或胃体癌行全胃切除术后的Roux-en-Y吻合相对上述方面,其优点相对突出,对于安全性、简单性及功能需求满足等均有较好的提升效果。After radical resection of gastric reconstruction clinical application rates higher, and this type of surgery in patients with postoperative digestive tract reconstruction of the related research and more and study involves the reconstruction of many kinds, studies have shown that the up to 70 species, for reconstruction of all the pros and cons of clinical controversy has been larger. Clinical requirements for digestive tract reconstruction of continuous improvement, the requirements mainly focus on in the following aspects：（1） Low complication rate.（2） The operation is simple.（3） It is easy to popularize.（4） Patients satisfactory nutritional status.（5） A good quality of life.（6） For postoperative endoscopy, X-ray barium meal check etc. After distal gastrectomy, the improved Billroth II and non intermittent Billroth II are the main advantages of the current reconstruction. Billroth I anastomosis reconstruction is affected by the scope of clinical application, and its application is also subject to a greater degree of limitation. In extension or stomach body cancer relative to the anastomosis after total gastrectomy, Roux-en-Y, and the utility model has the advantages of relatively prominent, for safety, simple and functional requirements to meet the has better promotion effect.

关 键 词：胃癌 根治术 消化道重建 并发症 

分 类 号：R735[医药卫生—肿瘤]