全胃切除术后消化道重建的方法及其评价

THE METHODS AND THEIR EVALUATION OF TRACT RECONSTRUCTION AFTER TOTAL GASTRECTOMY

48例全胃切除术的病人,分别采用了食管十二指肠吻合、食管空肠 Braun's 吻合、食管空肠 Roux-Y 吻合、食管ρ袢空肠 Roux-Y 吻合及间置ρ袢空肠插入代胃5种不同方式重建消化道。本文对这些术式的功能作用、不良反应及效果进行了观察研究,认为不同的术式具有其各自的特点,其中ρ袢空肠 Roux-Y 式吻合与间置ρ袢空肠代胃术式操作方便,并发症少,消化功能好,似更值得推崇。

In order to evaluate the different alimentary tract reconstruction methods after total gastrectomy,five types of reconstruction in 48 patients have been reported.The morbidity and mortality were receptable clinicaly in this group.Patients got normal or near normal quality of life postoperatively.The results suggest that the ρ-loop Roux-Y anastomosis and the ρ-loop interposition anastomosis are relatively better than others.However,each kind of methods has its own distinguished character,and likewise each individual has one's respective reaction to different methods.So far,neither a generally recognised,ideal procedure has been made,nor a procedure can suit to all patients clinicaly.It is necessary to consider the various condi- tion,prognosis,tolerance,socio-psychological state of the patients and the experience of the surgeon for pertinent choosing.The late literatures are reviewed and some common programs of reconstruction are discussed in this paper.