全胃切除术与近端胃切除术治疗胃上部癌术后发生反流性食管炎的关系探讨

Study on the Relationship between Postoperative Total gastrectomy、Proximal radical gastrectomy and Relfux Occurrence

目的通过对近端胃癌根治术二种术式术后反流性食管炎发生率的研究,探讨全胃切除+Roux-en-Y消化道重建术较近端胃切除、食管残胃后壁吻合术是否更为符合生理的手术方式。方法回顾性分析2007年10月至2014年1月,鄂尔多斯市中心医院收治的60例胃上部癌患者(30例行全胃切除+Roux-en-Y消化道重建术,30例行近端胃切除、食管残胃后壁吻合术)治疗的临床资料,术后随访1年内反流性食管炎的发生率。结果全胃切除+Roux-en-Y消化道重建术组反流性食管炎发生率为26.7%,显著优于近端胃切除、食管残胃后壁吻合术的80.0%(P<0.05)。结论全胃切除+Roux-en-Y消化道重建术对减少近端胃癌根治术后反流性食管炎的发生有明显效果。

Objective Through the restrospective analvsis of clinical data of two kinds of postoperative reconstruction of proximal gastric cancer and reflux occurrence ,to explore the total gastrectomy , Roux-en-Y anastomosis operation type , more in line with the physiolgy than proximal radical gastrectomy , anastomosis of posterior wall of esophagus residual stomach .Methods Sixty patients with proximal stomach cancer were enrolled from October 2007 to January 2014 in Ordos City Centre Hospital and underwent total gastrectomy（total gastrectomy group,n=30）and proximal radical gastrectomy （proximal radical gastrectomy, n=30 ） .The proportion of occurrence of reflux esophagitis were followed in one year after operation . Results The incidence of reflux esophagitis was 26.7%and 80.0%.Conclusion The total gastrectomy , Roux-en-Y anastomosis operation type ,decreases incidence of reflux esophagitis more obviously than proximal radical gastrectomy ,anastomosis of posterior wall of esophagus residual stomach .