【摘要】 目的探讨胃癌全胃切除消化道重建的改进方式——回盲部升结肠间置代胃术的优缺点。方法根据手术方式将216例全胃切除后消化道重建的病人分为3组:Ⅰ组,食管-空肠Schlatter法吻合术92例(42.59%);Ⅱ组,食管-空肠Roux-en-Y吻、合术103例(47.69%);Ⅲ组,回盲部升结肠间置代胃术21例(9.72%)。比较3种消化道重建方式的返流性食管炎、营养不良的发生率和食物储量的大小。结果返流性食管炎、营养不良发生率和食物储量在Ⅰ组术式中分别为32.61%、66.30%、200-250ml,在Ⅱ组术式中分别为23.30%、58.25%、180-220ml,在Ⅲ组术式中分别为0%、9.52%、350-400ml。结论在3种术武中,回盲部升结肠代胃术的返流性食管炎、营养不良的发生率最低(P<0.05),食物储量最大(P<0.05),是较理想的全胃切除后消化道重建术式。更多还原

【Abstract】 Objective Now we reconstruct the digestive tract mainly by Schlatter’s esophago jejunuostorny and Roux-en-Y’s esophago jejunuostorny. Since complication was easy to take place in above way this study is to probe the improving procedure of digestive tract reconstruction after total gastrectomy in the treatment for gastric carcinoma. Methods Two hundred and sixteen cases of gastric carcinoma with digestive tract reconstruction after total gastrectomy in our hospital since 1989 were divided into three groups according to operative method. Operative method Ⅰ group: Schlatter’s esophago jejunuostorny was used in 92 cases (42. 59%), operative method Ⅱ group: Roux-en-Y’s esophago jejunuostomy was used in 103 cases (47. 69%) , operative method Ⅲ group: Interpositional ileocaecogastroplasty was used in 21 cases (9. 72%) . The incidence of reflux esophagitis, malnutrition and the capacity of food-reserving of the three groups were compared respectively. Results The incidence of reflux esophagitis and malnutrition and the capacity of food-reserving was 32. 61%, 66. 30%, 200-250 ml respectively in the group Ⅰ. It was 23. 30% , 58. 25%, 180-250 ml respectively in the group Ⅱ. It was 0% , 9. 52%, 350-400 ml respectively in the group Ⅲ. Conclusion The interpositional ileocasecogastroplasty is an sensible digestive tract reconstruction after total gastrectomy for the incidence of reflux esophagitis and malnutrition was lowest (P<0. 05) and the capacity of food-reserving was largest (P< 0. 05) in the three groups.更多还原