胃癌全胃切除术后消化道重建方式的探讨

Study of alimentary reconstructions after total gastrectomy for gastric cancer

目的:探讨全胃切除术后消化道重建的合理术式。方法:研究分析1998～2007年我院收治的152例胃癌全胃切除患者的临床资料。分别采用顺蠕动食管空肠Roux-en-Y吻合术、逆蠕动食管空肠Roux-en-Y吻合术、Lahey氏食管空肠吻合术、Rantolan食管空肠吻合术和食管空肠P型吻合术五种方式重建消化道,对其进行回顾性分析,以术后的消化道症状和营养状况作为评价依据。结果:蠕动食管空肠Roux-en-Y吻合术有较强的抗反流作用,饮食限制少,患者的营养状况明显改善。结论:顺蠕动食管空肠Roux-en-Y吻合术,能有效地控制返流性食管炎、减少术后并发症和提高生活质量,是全胃切除术后一种较为合理的消化道重建方式。

Objective：To find an ideal reconstruction method after total gastrectomy for gastric cancer. Methods： From 1998-2007,152 patients underwent total gastrectomy, whose clinical data were analyzed. The five procedures are Roux-en- Y esophagojejunostomy, Roux-en Y reversed peristalsis esopbagojejunostomy, Lahey esophagojejunostomy, Rantolan esophagojejunostomy and esophagus P-type jejunal pouch Roux-en Y anastomosis. Results： Roux-en Y esophagojejunostomy have superiority in anti-esophagus reflux than the others, patients with Roux-en Y esophagojejunostomy reconstruction have better food intake and improve their nrtritional status significantly. Conclusions： The Roux-en-Y esophagojejunostomy can reduce the postoperative complications and improve the quality of life because of its eontroling effectively biliary reflux esophagitis,and it is one of the reasonable reconstructive procedures.