回盲肠间置代胃术在胃肠道重建术中的应用

The application of ileocecum interposition in alimentary reconstruction

目的 对回盲肠间置代胃术应用于胃肠道重建术中的临床前景做初步研究。方法 采用内镜检查、食管压力测定、２４ｈ食管ｐＨ监测、胃液总胆汁酸含量测定、上消化道钡餐透视和生存质量测定等多项指标检测方法，对８例回盲肠间置代胃术患者作代胃功能监测，并与同期１５例空肠代胃术患者或１５位正常人作对照。结果 回盲肠间置代胃术的回盲瓣有良好的抗胃食管反流作用。结肠有充分的容量，是一个良好的贮存袋。保留的幽门具有良好的抗碱性反流和防止胃排空过快作用。患者术后生存质量满意。结论 回盲肠间置代胃术是理想的、接近生理状态的胃肠道重建方法。

Objective To evaluate the clinical application of ileocecum interposition graft as gastric replacement in alimentary reconstuction. Methods Various methods including video-assisted gastroscopy, esophageal manometry, 24 h pH esophageal monitoring, total bile acids (TBA) in gastric fluid, barium meal examination of upper alimentary tract, quality of life (QOL) were used in stomach function monitoring on 8 cases after such reconstruction. Meanwhile, comparisons were performed with 15 cases after reconstruction of stomach with jejunum (RSJ) or 15 normal people. Results The ileocecal valve could replace the cardia and was possessed of good anti-gastroesophageal reflux capability. The ileocecum and ascending colon had sufficient capacity and was a good container. The retained pyloras proved efficient in anti-duodenogastric reflux and in lengthening gastric emptying time. Quality of life after operatin was satisfactory. Conclusion This surgical procedure is an ideal method of alimentary reconstruction which is close to physiological status.