全胃切除术治疗胃底贲门癌方法探讨

The study of total gastrectomy in the surgical treatment of cancer of stomach funds and cardia

目的:探讨全胃切除治疗胃底贲门癌的合理性和消化道重建方式。方法:回顾分析1995年6月-2006年6月对98例病变较晚的胃底贲门癌患者行全胃切除术的临床资料。结果:单纯开腹手术48例,胸腹联合切口50例,全部采用食管-空肠Roux-y吻合,根治性切除86例,姑息性切除12例,术后出现吻合口瘘2例,肺部并发症2例,返流性食管炎3例,膈下脓肿1例,无吻合口狭窄、乳糜胸及死亡病例,并发症发生率为8.2%(8/98)。结论:全胃切除、食管-空肠Roux-y吻合术是治疗胃底贲门癌比较理想的重建术式,病变切除范围广,淋巴结清扫彻底,具有一定的代胃功能和较强的抗返流作用。

Objective:To approach the rationalisation of total gastrectomy in the treatment of cancer of stomach funds and cardia,and the methods of alimentary tract reconstruction.Methods:The clinical data of 98 cases with cancer of stomach funds and cardia,that with the treatment of total gastrectomy,from June 1995 to June 2006,were analyzed retrospectively.Results:Of the 98 cases,48 cases were with the abdomen incision,50 cases with the thoracicoabdominal incision,and they were all adopted with Roux-en-Y reconstruct...