全胃切除术相关问题的分析  

The Investigation of Some Issues for Total Gastrectomy

作　　者：杨洲[1] 杨绍福[1] 

机构地区：[1]川北医学院附属医院,四川南充637000

出　　处：《川北医学院学报》2002年第3期63-65,共3页Journal of North Sichuan Medical College

摘　　要：目的总结和分析全胃切除术的适应证以及消化道重建方式与近期术后并发症的关系。方法回顾性分析 1991年至2 0 0 1年 6月间我院收治的 5 2例全胃切除术病例 ,其中胃癌 38例 (占 73 1% ) ,残胃癌及残胃再发癌共 6例 (占 11 % ) ,贲门癌12例 (占 2 3 1% ) ,食道腹段癌 2例 (占 3 8% )。结果本组无死亡病例 ,共采用了 5种不同的消化道重建方式。近期术后并发症中 ,吻合口瘘 3例 ,发生率 5 7% ;吻合口良性狭窄 1例 ,发生率 1 9% ;腹腔感染 5例 ,发生率 9 6 % ;肺合并症 4例 ,发生率7 7% ;胸腔积液 3例 ,发生率 5 8%。结论全胃切除术是一种对胃疾病有效的治疗手段 ,临床医生应根据患者的病情选择合适的消化道重建方式。Objective To study the surgical indication of the total gastrectomy and the relationship between the postoperative complication and the reconstruction of alimentary tract after total gastrectomy.Methods A Retrospective study of total gastrectomy from 1991 to June 2001 was performed. 52 cases with total gastrectomy were enrolled in this study during the period, including 32 cases of gastric cancer, 6 cases of gastric stump cancer, 12 cases of cardiac cancer and 2 cases of inferior segmental esophageal cancer.Results No operative death was noted, and anastomotic leakage occurred in 3(5 7%) patients. 1(1 9%) patient suffered from stenosis of anastomotic stoma and infection of abdominal cavity occurred in 5(9 6%) patients. The complication of lung occurred in 4(7 7%) patients and the hydrothorax in 3(5 8%) patients.Conclusion Total gastrectomy is an effective way in surgical treatment for disease of stomach. Surgeons should pay attention to choose the suitable case fitting the surgical indication and to use the correct method of the reconstruction of alimentary tract according to the patients' condition. Meanwhile, improving the patients' preoperative nutritional condition and better treated of the concomitant disease are essential to lower down the postoperative complications.

关 键 词：全胃切除术 消化道重建 近期并发症 适应证 胃癌 围手术期 

分 类 号：R656.61[医药卫生—外科学]