近端胃大部切除后食管残胃间空肠双“S”法吻合术效果探讨

Effect of modified double tracks anastomosis on proximal gastrectomy

目的 探讨理想的近端胃大部切除后消化道重建方法 ,减少术后反流性食管炎的发生。方法 对 1997— 2 0 0 1年 12 5例行近端胃大部切除术贲门癌患者资料进行回顾性分析 ,其中 5 8例 (A组 )做食管残胃间空肠双“S”法吻合术 ,6 7例 (B组 )做残胃食管吻合术 ,随访 6个月～ 2年 ,比较两组术后反流性食管炎的发生率。结果 患者均获得随访 ,A组有 4例发生反流性食管炎 ,B组有 15例 ,两组比较有显著性差异 (P <0 .0 5 ) ;两组胃镜下检出异常率分别为19%和 6 1% ,有显著性差异 (P <0 .0 5 )。结论 食管残胃间空肠双“S”法吻合术对预防近端胃大部切除术后反流性食管炎的发生效果显著 ,是近端胃大部切除后理想的消化道重建术式。

Objective It is to explore the ideal method of digestive tract reconstruction after proximal gastrectomy and decrease the incidence of reflux esophagitis. Methods 125 patients who had undergone proximal gastrectomy for carcinoma of gastric cardia were analyzed retrospectively. The modified double tracks anastomosis was used in 58 cases in group A. The esophagus-gastrostomy was used in 67 cases in group B. All were followed up for six months to two years and the incidence of reflux esophagitis was compared. Results All patients had been followed up. The incidence cases of reflux esophagitis in group A was 4 patients and which in group B was 15 patients. There was significant difference between two groups (P<0 05). Conclusion The modified double tracks anastomosis is an ideal procedure digestive tract reconstruction to prevent the incidence of reflux esophagitis after proximal gastrectomy.