完全游离残胃在消化道重建中的应用  

Oesophagoplasty Using a Completely Mobilized Remant Stomach

作　　者：付印[1] 黄杰[1] 康敢军[1] 谢颂平[1] 梁健[1] 

机构地区：[1]武汉大学人民医院胸外科,430060

出　　处：《医学研究杂志》2017年第3期56-60,共5页Journal of Medical Research

基　　金：湖北省自然科学基金资助项目(2014CFA070)

摘　　要：目的探讨完全游离残胃在消化道重建中的可行性和潜在优势。方法回顾性收集武汉大学人民医院胸外科自2005年8月~2016年6月间利用完全游离残胃重建消化道治疗65例原发性食管癌患者的临床资料。分析65例患者的手术时间、术中出血量、住院时间、术后并发症、术后生活质量等情况。结果 65例患者肿瘤均完整切除并行二野淋巴结清扫,术中快速冷冻病理切片示食管残端阴性;平均手术时间311.3±25.2min,平均术中出血量355.6±15.8ml,平均术后住院时间12.5±2.1天;吻合口瘘1例,胃壁瘘1例,出现输入袢综合征2例,经积极对症治疗后均痊愈出院;65例均恢复经口进食。结论完全游离残胃代食管治疗原发性食管癌是一种可靠的手术方式,创伤较小,操作简单,容易掌握,是一值得推广术式。Objective To determine the feasibility and possible superiority of oesophagoplasty using a completely mobilized remant stomach. Methods Clinical data of 65 patients＇who have developed esophageal cancer following distal gastrectomy and used a completely mobilized remant stomach for oesophagoplasty in Renmin Hospital of Wuhan University from August 2005 to June 2016 were retrospectively reviewed. Analysis of 65 cases of patients with operation time, intraoperative blood loss, hospital stay, postoperative complications, post- operative quality of life, and so on was made. Results The tumor of the 65 cases was complete resection and 2 - field lymph node dissection was done, frozen sections of the surgical margins was negative. Average operation time was 311.3 ±25.2min, mean intraoperative blood loss was 355.6 ±15.8ml, average postoperative hospital stay was 12.5 ±2. ldays. 1 （1.5%） patients had an anastomotic leak, 1 （1.5%） patients experienced gastric fistula,2（3.0% ）patients had afferent loop syndromeme, after actively symptomatic treatment the four patients recovered and discharged from hospital. All of the patients resumed oral feeding. Conclusion oesophagoplasty using a completely mobilized remant stomach is feasible and simple. It is worth promoting.

关 键 词：食管癌 胃大部切除术 残胃 消化道重建 

分 类 号：R459.9[医药卫生—治疗学]