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目的设计一种能有效防止反流性食管炎的近胃端切除术后消化道的重建方式。方法福建省晋江市医院2007年3月至2008年7月间对36例近端胃恶性肿瘤的病人采用间置空肠“双通道”消化道重建并进行临床观察。结果全组病例无围手术期死亡,无吻合口漏、倾倒综合征发生。手术时间和出血量无明显增加。约90%以上病人术后半年每日进食3～4次,每餐进食200～400g,通过胃镜检查未出现严重反流性食管炎的病例,89%病人甚至无食管炎的症状,体重基本恢复至术前水平。结论间置空肠“双通道”较好地解决了反流性食管炎的发生,明显改善了病人的生活质量,并且术后化疗的依从性也得到了保证,是一种近端胃大部切除后消化道重建的颇为理想的术式。
Objective To design a method of reconstructing the digestive tract after near-gastric resection that can effectively prevent reflux esophagitis. Methods Between March 2007 and July 2008, 36 patients with proximal gastric cancer were treated with indirect jejunal “double channel” gastrointestinal reconstruction and clinical observation. Results All the patients did not have perioperative death, no anastomotic leakage and dumping syndrome. No significant increase in operative time and bleeding volume. About 90% of patients after six months of eating three to four times daily, each meal eating 200 ~ 400g, by gastroscopy did not appear serious reflux esophagitis cases, 89% of patients even without esophagitis symptoms, weight recovery To the preoperative level. Conclusion Interstitial jejunum “double channel ” solves the incidence of reflux esophagitis, significantly improves the patient’s quality of life, and the compliance of postoperative chemotherapy is also guaranteed, is a proximal stomach After resection of the digestive tract reconstruction is quite ideal operation.