经腹经纵隔全胃或次全胃切除47例分析

Total or subtotal gastrectomy for gastric carcinoma by transabdominal and intramediastinal pathway:a report of 47 cases.

目的探讨胃肿瘤行全胃或次全胃切除的路径及合理的消化道重建方式。方法1997-2005年对47例胃上部及贲门肿瘤行经腹经纵隔全胃或次全胃切除、结肠段消化道重建术,对其手术方法、手术并发症、术后消化道症状进行观察。结果术后发生食管横结肠吻合口漏1例,余46例无吻合口漏及术后消化道等并发症。与经胸腹手术相比,具有创伤小,并发症少,恢复快等特点。结论经腹经纵隔全胃或次全胃切除、结肠段消化道重建是一种安全、实用、疗效满意的手术方法,术后加强营养支持治疗,可明显提高病人的生存质量。

Objective To explore the ideal procedure of total or subtotal gastrectomy and digestive reconstruction in gastric carcinoma. Methods From 1997 to 2005, forty-seven cases of upper gastric carcinoma and cardial carcinoma received total or subtotal gastrectomy by transabdominal and intramediastinal pathway while digestive reconstruction with colon. The skills, the complications and symptoms of alimentary tract of operation were observed. Results There was one case anastomotic leakage and no other complications occurred in other 46 cases. The operation was showed as fewer traumas,less complication,and rapid recuperation compared with thoracolaparotomy. Conclusion Total or subtotal gastrectomy by transabdominal and intramediastinal pathway while digestive reconstruction with colon is safe, practical and satisfied. Survival quality of patients is improved with nutrition after operation.