胃癌袢式空肠代胃改良Ⅰ式术后患者对化疗耐受性观察

Observation of chemotherapy tolerance in patients with gastric cancer treated by modified Ⅰ type loop jejunum reconstruction

目的:探讨胃癌全胃切除患者袢式空肠代胃改良Ⅰ式消化道重建术的手术疗效及对术后辅助化疗的安全性和耐受性的影响。方法:收治进展期胃癌患者28例,均实施全胃切除袢式空肠代胃改良Ⅰ式消化道重建术,观察治疗效果及对术后辅助化疗的安全性和耐受性的影响。结果:28例患者均未发生严重手术并发症,21例患者顺利完成辅助化疗6周期,7例患者因出现严重消化道反应或出现血小板毒性而中断化疗,停止化疗后症状逐渐好转。结论:胃癌患者实施全胃切除选择袢式空肠代胃改良Ⅰ式消化道重建方式安全可行,术后按奥沙利铂+替吉奥方案辅助化疗,75%患者可耐受化疗,25%患者中断化疗,中断化疗主要原因是严重消化道反应及血小板毒性。

Objective:To explore the operative effect of patients with gastric cancer and total gastrectomy treated by modified Ⅰtype loop jejunum reconstruction and its impact on the safety and tolerability of postoperative adjuvant chemotherapy.Methods:28patients with advanced gastric cancer were selected.They were treated with total gastrectomy modified Ⅰ type loop jejunum reconstruction.We observed the effect of treatment and its impact on the safety and tolerability of postoperative adjuvant chemotherapy.Results:28 patients had no serious complications.21 patients successfully completed adjuvant chemotherapy in the6 cycles.7 patients discontinued chemotherapy because of severe gastrointestinal reactions or platelet toxicity.After cessation of chemotherapy,the symptoms were gradually improved.Conclusion:The application of total gastrectomy modified Ⅰ type loop jejunum reconstruction for patients with gastric cancer was safe and feasible.After the operation,they were given adjuvant chemotherapy with oxaliplatin plus s-1.75% of the patients were tolerable,and 25% patients discontinued chemotherapy.The main causes of interruption of chemotherapy were severe gastrointestinal reaction and platelet toxicity.