经腹近侧胃切除空肠间置术的体会

本文报告经腹近侧胃切除行空肠间置术21例。介绍了行R_2近侧胃切除后,切取带蒂之空肠段25～30cm,于结肠后,将空肠近侧端与食管吻合,远侧端与残胃吻合重建消化道。该术式利用空肠段的顺向蠕动阻止酸/苦消化液逆入食管,有效地防止了反流性食管炎。对预防吻合口瘘及狭窄也有一定作用。作者认为经腹手术一般不需全麻,对高龄、体弱及有心肺合并症之贲门癌患者更为有利。

Experiences in Reconstruction of Alimentary Continuity with Pedicled Jejunal Segment Interposition after Proximal Gastrectomy

A series of 21 cases of transabdominal proximal gastrectomy with a pedicled segment of jejunum interposing the gap were reported. After proximal gastrectomy of the R2 mode a 25-30 cm long jejunal segment with vascular pedicle was interposed between cut ends of esophagus and stomach. This method can effectively prevent re- flux esophagitis, anastomotic fistula and postoperatiye constriction. The proximal gastrectomy done through the abdominal approach often does not need general anes- thesia and is good for elderly, weak patients and patients with cardiac or pulmonary diseases.