【摘要】 目的:探讨胃癌根治术中保留幽门的价值。方法:回顾总结胃癌根治术后行调节型双通道间置空肠消化道重建病例69例。依据保留幽门与否分为两组:幽门保留组(PPG组,31例)、不保留幽门组(nPPG组,38例)。主要对比分析两组术后生活质量。结果:病例无围手术期死亡、吻合口漏、倾倒综合征及中度以上贫血病例发生。两组术后营养学状态差异无显著性(P>0.05)。PPG组术后腹胀、恶心、呕吐、胸骨后烧灼痛、反酸、嗳气等消化道症状重于nPPG组。Visick评分(P=0.006):PPG组主要为Ⅱ级(74.2%),nPPG组主要为Ⅰ级(92.1%)。结论:调节型双通道间置空肠消化道重建在保留幽门与否的根治性全胃(近端次全胃)切除术中是安全、可行的。保留幽门并不能进一步改善生活质量,主要表现在PPG组有更多、更重的上腹饱胀症状。更多还原

【Abstract】 Objective:To explore the value of pylorus-preserving gastrectomy.Methods:We reviewed a number of 69 patients who underwent radical gastrectomy with accommodative double tract digestive reconstruction of jejunal interposition during June 2004 and Janurary 2007 retrospectively.All patients were divided into 2 groups according to pylorus-preserving or not:one group with pylorus-preserving gastrectomy(PPG,31cases) and another without pylorus-preserving gastrectomy(nPPG,38cases).We comparatively analyzed the quality of life between the 2 groups mainly.Results:All patients did not died and had no anastomotic leakage,dumping syndrome and anemia severe to moderate in perioperative period.There were no significant difference of postoperative nutrition status in the two groups(P>0.05).It was more serious in group PPG with postoperative epigastric fullness,nausea,vomiting,burning substernal pain,acid reflux,belching,etc.Visick score(P=0.006):PPG group mainly grade Ⅱ(74.2%),nPPG group mainly grade Ⅰ(92.1%).Conclusion:The accommodation double tract digestive reconstruction of jejunal interposition for radical total gastretomy(proximal subtotal gastretomy) with pylorus-preserving or not is safe and feasible.Pylorus preserved does not further improve the quality of life.In PPG patients,more frequent and severe symptoms of epigastric fullness are experienced.更多还原