保留幽门全胃切除间置空肠代胃术

Preservation of Pylorus and Reconstruction of Alimentary Tract in Total Gastrectomy

报告6例贲门胃底癌及胃体上部癌行根治性全胃切除，保留幽门问置空肠代胃术的临床效果。选择5、6组淋巴结无转移，不影响根治效果的6例病人，行保留幽门全胃切除术后，将25cm空肠间置于食管与十二指肠之间。术后通过临床观察，上消化道锁餐X线摄片、电子纤维胃镜检查及食管、问五空肠活检等证明此术式有良好的抗返流作用，并延长了食物在“代胃”内停留时间，幽门录作用正常。术后3个月、半年、1年钡餐摄片观察代胃扩张，幽门开放功能良好，无返流现象；术后半年、1年、2年电子胃镜检查并活检，无返流性食管炎发生。生存期与同期不保留幽门间置空肠代胃术相比，无显著性差异。

簉eservation of pylorus was practiced in total gastrectomy on 6patients with gastric carcinoma of the cardia or fundus. The postoperative barium meal and fibergastroscopy with biopsy were performed- During a period of 2-year follow-up no reflux esophagitis was found. It is suggested that this kind of operation has the benefits of anti-reflux, delayed food evacuation and preservation of the normal gastro-pyloric pump function.