胃癌全胃切除术P式空肠代胃术探讨

“p” style of total gastrectomy in carcinoma of stomach

目的:讨论理想的全胃切除术后消化道重建方式。方法:对2000年~2005年经病理证实胃癌行全胃切除术P式空肠代胃重建53例进行回顾性分析。观察术后并发症,术后恢复情况、代胃贮袋的效果。结果:全组无手术死亡及吻合口瘘及狭窄发生,术后半年内均恢复每日3~4餐的饮食习惯,日均进食量为400g^600g,基本恢复工作能力。结论:P袢代胃操作简单易行,手术时间短,不仅减少“无胃综合征”且很少发生返流性食道炎和倾倒综合征及吻合口瘘,是全胃切除术后理想的消化道重建方式。

Objective：To disscuss an ideal way to reconstruct the digestive canal after total gastrectomy. Methods： We analyzed 53 cases of carcinoma of stomach confirmed by pathology retrospectively between 2000 - 2005, every patient was carried out ＂p＂ style of total gastrectomy and reconstructed digestive canal by using jejunal, and observed the complications and effect of the bag for the stomach. Results： There was no death, stenosis, and leakage 3 - 4 times and 400 - 600g per day for meal recovered in all of the cases, basically recovery in work capability. Conclusion： ＂p＂ style operation in gastric cancer is easy to perform and save time, it is not only diminishing in agastria syndrome but also seldom of reflux esophagitis and dumping syndrome, rare of leakage in anastomotic stoma, so this is an ideal way to reconstruct the digestive canal after total gastrectomy.