全胃切除改良Lawrence法消化道重建的意义

Significance of modified Lawrence＇s reconstuction procedures following total gastrectomy for gastric cancer

目的探讨胃癌全胃切除术改良Lawrence法消化道重建对患者营养吸收的影响。方法对76例全胃切除患者，行改良Lawrence法消化道重建3个月和6个月的营养状况及消化道症状进行回顾性分析。结果76例患者中48例患者于术后3个月行钡餐检查，钡剂排空时间为60～100min，站立位与平卧位均未见钡剂反流入食管，无吻合口狭窄的征象。分别于术后3个月和6个月复查血红蛋白、总蛋白、体重、进食量，均达到或接近术前水平。结论该术式使患者在术后短期内恢复正常饮食习惯，手术操作简便、安全，是全胃切除术后一种理想的消化道重建术式。

Objective To explore the influence of modified Lawrence＇s reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence＇s reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 rain, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotie stoma. The hemoglobin, total protein, body weight and food- intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence＇s reeonstuetion procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.