吻合口溃疡的外科治疗

Surgical treatment of stomal ulcer

目的探讨胃大部切除术后吻合口溃疡发生的主要原因和手术治疗方法。方法回顾性分析1995年6月-2006年10月间经手术治疗的5例吻合口溃疡患者的临床资料。结果5例患者均经原吻合口切除和胃空肠Roux-en-Y吻合术，术后随访1～5年无溃疡再发。结论胃大部切除术后发生吻合口溃疡的主要原因与第一次手术切除胃的范围不足有关。对出现并发症的吻合口溃疡患者应采取外科手术治疗；原吻合口切除和胃空肠Roux-en-Y吻合是治疗吻合口溃疡的有效手段。

Objective To investigate the reasons of stomal ulcer after subtotal gastrectomy and the methods of surgical therapy.Methods The clinical data of 5 cases of stomal ulcer after subtotal gastrectomy admitted from June 1995 to October 2006 were retrospectively analysed.Results The postoperative cure rote was excellent.No reoccurred ulcer appeared after 1 to 5 years of followup. Conclusion Inadequate gastric resection is the main cause of stomal ulcer;surgical therapy is the choice for the recurrent stomal ulcer with complications; Stomal resection and gastrojejunal Roux-en-Y anastomosis are effective methods to treat the stomal ulcer.