摘要
目的:探讨胃癌全胃切除术后消化道重建的理想术式。方法:在全胃切除后,制作一个“S”或“W”形空肠贮 袋,与食管做双道吻合。结果:21例患者无并发症发生,经钡透检查均有钡剂通过十二指肠,钡剂进入量为20%～80%,且存 钡时间最长者超过120分钟,分别于术后1月和3月复查,血红蛋白、总蛋白、体重、进食量均达到或超过术前水平。结论:该 术式使重建消化道的食物储存容量增加,排空时间延长,且降低了吻合口瘘、狭窄、倾倒综合征和返流性食管炎的发生率;更 多的食物通过十二指肠的正常生理途径,使进食与消化液分泌得以同步进行,同时,手术操作较代胃手术简便、安全,是全胃 切除术后值得选择的一种消化道重建术式。
Objective:To explore a new ideal operation style for the reconstruction of the alimentary tract after total gastrectomy.Methods:A storable jejunum bag with a shape of “S”or “W”was made after total gastrectomy.The ends of the esophagus, duodenum and jejunum were anastomosed with the side of the jejunum at different levels.Double tracts, duodenum-jejunum tract and jejunum tract were formed under the storable jejunum bag.Results:No complications occurred to any patients.About 20%～80% barium contrast passed through the duodenum-jejunum tract in all the 21 patients during the X-ray fluoroscopy.The barium contrast could be sustained in the reconstructed alimentary tract for over 120 minutes.During the follow-up at the end of the first month and the third month after operation, it was found that the levels of hemoglobin, total protein, body weight and the amount of each meal of the patients were as high as or higher than those before operation.Conclusion:This style of operation could increase the amount of food stored in the reconstructed alimentary tract, postpone discharging of food,decrease the incidence of stomal leakage,stomal stenosis, dumping syndrome and reflux esophagitis.Since more food could enter the duodenum which is the normal physiological pathway,taking in food would lead to the secretion of digestive juice.This kind of operation is simpler and safer than the operation of stomach substit,therefore,it is a alternative modality for the reconstruction of alimentary tract after total gastrectomy.
出处
《临床肿瘤学杂志》
CAS
2005年第1期55-57,共3页
Chinese Clinical Oncology
基金
青岛市科研基金资助项目(2003-WSJH031)
