胃窦癌远端胃大部切除后胃空肠Rouxen-Y重建的效果

Clinical Investigation of the Roux-en-Y Gastrojejunostomy after Subtotal Gastrectomy for Carcinoma of Gastric Antrum

目的 评价胃窦癌施行根治性或姑息性远端胃大部切除后采用胃空肠Roux -en -Y重建的效果。方法 对接受该项手术的 118例病人的临床、病理和随访资料进行分析 ,与同期采用其他重建方式的病人进行对比。结果 Roux en Y组近期效果与其他重建组无区别 ,远期随访无胆汁反流性胃炎、Roux淤积综合征和倾倒综合征。生存质量有所提高 ,Visick评级多属于Ⅰ～Ⅱ级 ,2年存活率高于其他组。结论 与BillrothⅠ和Ⅱ重建相比 ,Roux en Y重建常可获得较好的生存质量和较长的生存时间 ,可作为胃窦癌远端胃大部切除后胃肠道重建的首选方法。

Objective To evaluate the effectiveness of Roux en Y (R Y)reconstruction after radical or palliative subtotal gastric resection for carcinoma of gastric antrum.Methods A retrospective study was undertaken in 118 patients with carcinoma of gastric antrum who underwent radical or palliative subtotal gastirc resection.Clinicopathological and follow up data relating to survival,and quality of life were compared with patients underwent Billroth Ⅰ(BⅠ) or Billroth Ⅱ(BⅡ) procedures.Results The postoperative morbidity and mortality rates were no significant difference between the three groups in early.There were no development of allkaline reflux gastritis,R Y stasis syndrome and dumping syndrome in long term follow up.The quality of life the R Y group were better with VisickⅠ to Ⅱ,and the 2 years survival rate was higher than that of other group.Conclusion Comparing with conventional BⅠ and BⅡ,R Y reconstruction group often obtain better quality of life and longer survival time,is first choice method after radical or palliative subtotal gastric resection for carcinoma of gastric antrum