胃癌全胃切除术后消化道重建方式的选择

目的：探讨全胃切除术后较理想的消化道重建方式。方法：对近6年来122例施行全胃切除术患者的临床资料进行回顾性分析。全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。结果：3种术式在食后烧灼感、进食量、进食次数、体重下降、倾倒综合征、血红蛋白、白蛋白等指标的比较，无明显差异（均P>0.05）。P型空肠袢食管空肠Roux-en-Y吻合术组所用手术时间显著多于Orr组及反口组（P<0.05）。反口组的贮袋大小及半排空时间显著优于Orr组及P袢组（P<0.05）。结论：远端空肠反口贮袋的Roux-en-Y吻合术是一种值得推荐的新型全胃切除术后消化道重建方法。

Digestive tract reconstruction after total gastrectomy for gastric cancer

Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy.Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were(analyzed) retrospectively.Three types of reconstruction procedures,including Orr-type Roux-en-Y(esophagojejunostomy),P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy,were performed.Results There were no significant differences among the three procedures in heartburn and the amount of food intake,frequencies of meal,weight loss,dumping(syndrome),and hemoglobin and albumin levels.The operation time in P-type group was longer than the other two group(P<0.05).The size of pouch and pouch emptying function in aboral pouch group were(significantly) superior to the other groups.Conclusions Distal jejunal aboral pouch Roux-en-Y(esophagojejunostomy) can be recommended as a new procedure for digestive reconstruction after total(gastrectomy.)