摘要
目的探讨理想的全胃切除术后消化道重建方式。方法总结分析1996年1月—2006年5月行全胃切除分别采用袢式空肠代胃+双Braun吻合(双Braun组)和P式Roux-en-Y吻合(P-Ry组)两种方式重建消化道的116例患者临床资料,以术后的消化道症状和营养状况作为评论依据。结果两组患者术后1年复查早饱感、倾倒综合征及反流性食道炎,双Braun组依次为1例(1.69%),3例(5.08%),2例(3.39%);P-Ry组依次为13例(22.81%),10例(17.54%),8例(14.04%)。与P-Ry组比较,双Braun组进餐早饱感发生率低(P<0.01),倾倒综合征发生率低(P<0.05),反流性食道炎发生率低(P<0.05)。但反映营养状况的体重变化、血红蛋白、血浆总蛋白、白蛋白等指标两组间无显著性差异(P>0.05)。结论与P-Ry吻合组比较,双Braun吻合组术后患者自觉症状少,生活质量较高,是比较理想的重建术式。笔者认为,全胃切除的患者应优先选用袢式空肠代胃+双Braun吻合术式。
Objective To explore the ideal mode of degestive tract reconstruction after total gastrectomy. Methods One hundred and sixteen gastric cancer patients, who underwent one of two reconstruction procedures between Jan 1996 and May 2006, were retrospectively evaluated with regard to their digestive symptoms and nutritional status. The two procedures were double Braun anastomosis （double Braun ） and P-Roux-en-Y reconstruction （ P-Ry ）. Results Follow up of the 2 groups, at one year after operation, showed the frequency of early satiety, reflux esophagitis and dumping syndrome in the double Braun group was 1（ 1. 69 %）, 3 （5. 08 %）, and 2 （3. 39 %） cases, respectively, and in P-Ry group was 13 （22.81%）, 10（17.54%）, and 8（14.04%） cases, respectively. Compared with P-Ry group, the frequency of reflux esophagitis in double Braun group was less （ P 〈 0. 05 ） ; and in doubl Braun group, patients had better food intake and lower rate of early satiety （ P 〈 0. 01 ） , and rate of dumping syndrome was less （ P 〈 0. 05 ）. But no difference was found in nutritional status （ body weight and serum nutrition parameters ） between the two groups （P 〉 0. 05 ）. Conclusions Compared to P-Ry group, the postoperative quality of life was better and the subjective symptoms were fewer in patients of double Braun group. So authors considerate that after total gastrectomy double Braun anastomosis is a relatively ideal alimentary tract reconstruction method. Double Braun anastomosis is recommended as the method of choice for patients undergoing total gastrectomy.
出处
《中国普通外科杂志》
CAS
CSCD
2007年第9期875-878,共4页
China Journal of General Surgery
关键词
胃肿瘤/外科学
全胃切除
消化道重建
Stomach Neoplasms/surg
Total Gastrectomy
Digestive Tract Reconstruction
