胃癌根治Roux-en-Y式重建术后胃瘫的治疗体会

目的 探讨胃癌根治Roux-en-Y式重建手术技巧与胃瘫发生的关系及治疗、预防办法.方法 回顾分析总结6年间21例胃癌根治术Roux-en-Y式吻合发生胃瘫综合征的患者资料.结果 21例胃瘫患者经非手术治疗后均获得成功,2周内恢复1例,3周内恢复2例,4周内恢复6例,5周内恢复10例,另2例紧张情绪较重患者,1例于术后8周恢复,另1例于术后9周恢复.结论 根治清扫术后的淋巴渗出、小弯侧切线过高、胃肠吻合口位置及吻合方式与术后胃瘫的发生有关,积极全面的保守治疗可治愈胃癌术后胃瘫综合征.

Treatment experiences in gastroparesis syndrome after radical gastrectomy with Roux-en-Y reconstruction for gastric carcinoma

Objective To explore the relationship between surgical techniques and postoperative gastroparesis syndrome after radical gastrectomy with Roux-en-Y reconstruction for gastric carcinoma and investigate the prevention and treatment methods.Methods The clinical data of 21 patients with postoperative gastroparesis syndrome after radical gastrectomy with Roux-en-Y reconstruction for gastric carcinoma were retrospectively collected in the past six years.Results All 21 patients were cured by conservative treatment,including 1 case recovered within two weeks,2 cases recovered within three weeks,6 cases recovered within four weeks and 10 cases recovered within five weeks.In the other two cases of mental stress,one case recovered within eight weeks,the other case recovered within nine weeks.Conclusion The occurrence of postoperative gastroparesis syndrome may be related to the lymph effusion,excess excision of the lesser curvature side and the location and style of the gastrointestinal anastomosis.It can be cured after a positive and comprehensive conservative treatment.