近端胃大部分切除术后行胃空肠Roux-en-Y吻合术对猪反流性食管炎的预防作用

THE EFFECT OF PREVENTING POSTOPERATIVE REFLUX ESOPHAGITIS WITH ROUX-EN-Y GASTROJEJUNOSTOMY AFTER PROXIMAL SUBTOTAL GASTRECTOMY IN SWINE

目的 :探讨近端胃大部分切除术行胃食管吻合、胃空肠 Roux- en- Y吻合术对猪反流性食管炎的预防作用。方法 :选用同窝小猪 4对 ,分别随机分为实验组和对照组。同时行近端胃大部分切除术和胃食管吻合术 ,对照组外加幽门成形术 ,实验组外加胃空肠 Roux- en- Y吻合术。饲养 3个月后处死 ,分别取距离食管胃吻合口 0、5、10 cm处食管组织行病理检查炎症反应。结果 :实验组的食管炎症反应显著低于对照组 (P <0 .0 5 ) ,实验组比对照组低。结论 :与传统近端胃大部分切除术相比 ,外加胃空肠吻合术可明显降低食管炎的发生 ,应用临床后有可能降低食管炎症反应而降低反流性食管炎的作用。

Objective:To prospectively study the effect of preventing postoperative reflux esophagitis with esophagogastrostomy and Roux-en-Y gastrojejunostomy after proximal subtotal gastrectomy in swine.Methods:4 pairs of littermate swines were allocated randomly to 2 groups(the control group and the experimental group).After proximal subtotal gastrectomy and esophagogastrostomy,the control group underwent pyloroplasty while the experimental group with Roux-en-Y gastrojejunostomy.The awine were killed after three-month breeding, and the inflammatory reaction of esophageal tissue in the distance of 0,5 cm and 10 cm from the suture of oesophagogastrostomy was pathologically studied respectively.Result:There were significant differences between the control group and the experimental group (P<0.05), and the inflammatory reaction in the experimental group was slighter than in the control group (P<0.05).Conclusion:Compared with traditional proximal subtotal astrectomy, the additional Roux-en-Y gastrojejunostomy decreases the esophagitis,and the clinical application of it has the possibility of decreasing the esophageal inflammatory reaction and accordingly it reduces the incidence of reflux esophagitis.