Roux-en-Y全口胃空肠端端吻合术

Full-mouth and End-to-end Roux-en-Y Gastrojejunostomy

目的 探讨胃大部切除术后更加符合生理的消化道重建方式。 方法 回顾性分析 5 2例胃癌、胃溃疡和十二指肠球部溃疡的病人在胃大部切除后行Roux en Y全口胃空肠端端吻合术的临床资料。 结果 全组无手术死亡 ,10d恢复正常饮食 ,术后发生并发症 6例 ( 11.5 % ) ,其中切口感染 3例 ,肺部感染 2例 ,粘连性肠梗阻 1例 ,均经保守治疗后痊愈出院。全组病人手术后无饱胀、食欲不振等症状 ,无倾倒综合征。有 4 2例手术后体重增加。随访 4 3例 ,时间 1～ 5年 ,死亡 4例 ,其中 3例死于胃癌肝腹腔转移 ,1例死于冠心病、肺部感染。 结论 该手术保留了重建消化道神经 -肌肉功能的连续性 ,对于减少胃大部切除术后并发症、提高生活质量有重要的临床意义 。

Objective To explore the method of digestive tract reconstruction more suitable to physilogical function after subtotal gastrectomy.MethodsDatas were retrospectively analyzed in 52 patients with gastric cancer,gastric ulcer and duodenal ulcer underwent the full mouth and end to end Roux en Y gastrojejunostomy after subtotal gastrectomy. Results No patients died during the operation. All patients recovered with normal diet in 10 days. The postoperative complication occurred in 6 patients, including 3 of incision infection, 2 of pulmonary infection and 1 of adhesive intestinal obstruction. They all cured after concervative treatment. No abdominal distention, anorexia or dumping syndrome occurred. 48 cases gained in weight postoperatively. 43 cases were followed up for 3 to 5 years, in whom 4 cases died. Among them 3 cases died of liver and celiac metastasis, 1 died of coronary heart disease and pulmonary infection. conclusion The full mouth and end to end reconstructive procedure is one of the reasonable method to reduce the postoperative complications and improve the quality of life with continuity of neuromuscular function.