横结肠间置代胃术的临床研究

A Clinical Study of the Transverse Colon Interposition after Total Gastrectomy

目的探讨带蒂横结肠间置代胃在全胃切除消化道重建中的临床应用价值。方法将89例全胃切除行消化道重建的胃癌患者分成2组:A组(46例)行带蒂横结肠间置代胃术;B组(43例)行食管空肠Roux-en-Y吻合术。比较2组术后一般情况、营养状况、生活质量、体质量、血液营养学指标及胃肠道症状。结果术后6月检测血红蛋白、血浆蛋白、体质量变化、出现返流性食管炎、倾倒综合征情况、"代胃"的容量、"代胃"肠管扩张情况、钡剂排空时间,A组参数指标均优于B组,差别具有统计学意义(P<0.05)。结论带蒂横结肠间置代胃术是全胃切除术后消化道重建的一种可供参考的较合理术式。

Objective To assess prospectively the clinical value of the transverse colon interposition after total gastrectomy.Methods 89 cases of gastric carcinoma with digestive tract reconstruction after total gastrectomy were divided into two groups according to operation method.In group A（n=46）,the transverse colon interposition was used,while in group B（n=43）,Roux-en-Y esophagojejunuostomy was used.Nutritional parameters,quality of life,body weight,serum nutritional parameters,gastrointestinal symptom were respectively evaluated after surgery.Results Six months after surgery,the hemoglobin level,the total protein level,the body weight loss,the incidence of reflux esophagitis and dumping syndrome,the capacity of transverse colon interposition,the dilatation of transverse colon interposition and the time of the bariums entered into duodenal channels were better in group A than those in group B.There were significant differences between these two groups（all P0.05）.Conclusion Transverse colon interposition after total gastrectomy is a better surgical method for reference.