空肠间置术在胸腹联合Ⅱ型贲门癌中的应用

Application of jejunal interposition in thoracic-abdominal operation of type Ⅱ gastric cardia carcinoma

目的探讨贲门癌胸腹联合切除术后合理的消化道重建方法及对术后生活质量的影响。方法回顾性分析食管残胃间空肠间置组(重建组)16例和食管残胃吻合组(对照组)的贲门癌患者18例,分别观察术后1个月、3个月、6个月、9个月、12个月反流性食管炎发生情况及体重变化情况。结果两组患者术后1个月、3个月、6个月、9个月、12个月烧心、反流严重程度评分重建组明显低于对照组,两组比较差异有显著性,P<0.05;两组患者术后3个月、6个月、9个月体重变化情况评分,重建组明显低于对照组,两组比较差异有显著性,P<0.05。结论空肠间置术手术时间相对延长,术后并发症并未增加,术后烧心、反流症状减轻,生活质量明显改善,体重及营养恢复较快,是胸腹联合Ⅱ型贲门癌根治术后较合理的消化道重建方法。

Objective To discuss the ideal method of digestive tract reconstruction after radical proximal gastrectomy with thoracoabdominal incision. Methods 16 Patients in the experimental group treated by jejunal interposition technique; other 18 patients received gastroesophagostomy. The occurrence of reflux esophagitis and the nutritional status 1,3,6,9, 12month after operation were evaluated. Results The difference of the occurrence of reflux esophagitis 1,3,6,9,12month and the nutritional status 3,6,gmonth after operation between two groups were statistically significant; Conclusion The je- junal interposition technique after radical proximal gastrectomy with thoracoabdominal incision is an ideal method of diges- tive tract reconstruction. The postoperative complications of the jejunal interposition group were not improve. It can improve the quality of life.