全胃切除消化道重建术式探讨

Approach of reconstructive styles of alimentary canal after total gastrectomy

目的探讨全胃切除术后合理的消化道重建方式。方法对256例行全胃切除术的患者采用了3种不同的消化道重建术式,对其术后1 a、3 a饮食状况及营养指标进行对比观察。结果Roux-en-Y吻合术和Tanner"9"形吻合术术后能有效地防止反流性食管炎,明显优于Omega式吻合术。Roux-en-Y吻合术与Tanner"9"形吻合术相比,操作更简单,而效果相似。结论Roux-en-Y吻合术是全胃切除术后消化道重建较为合适的术式。

Objective It is to approach the suitable styles of alimentary canal reconstruction after total gastrectomy. Methotis The alimentary canal of 256 cases after total gastrectomy were reconstructed by 3 modus operandi, Then the body weight, hemoglobin, plasma protein and incidence of reflux esophagitis of pre-and post-operation were observed at 1 year and 3 year after surgery. Results General type Roux-en-Y esophagojejunostomy and Tanner-type esophagojejunostomy played a role in antiesophagealreflux. Both of the reconstructive modus were obviously superior to Omega-type anastomosis. Compared with Tannertype group, operation of General type Roux-en-Y was simpler, operative time was shorter, and the clinic effect was similar. Conclusion General type Roux-en-Y esophagojejunostomy is a better method of alimentary canal reconstruction after total gastrectomy for gastric malignant tumor.