胃癌患者全胃切除术后两种消化道重建术式的对比研究

目的 比较全胃切除术后两种消化道重建方式的临床应用价值.方法 8 4例胃癌患者,全胃切除术后,给予Orr式Roux-en-Y空肠食管吻合术或者P形空肠袢Roux-en-Y空肠食管吻合术进行消化道重建,比较两组手术时间、术后并发症和术后消化道症状.结果 两种术式在术后消化道症状,如腹泻、倾倒综合征和返流性食管炎的发生率方面无明显差异(P＞0.05),P形空肠袢Roux-en-Y空肠食管吻合术术后并发症稍高,但差异也无统计学意义(P＞0.05),而Orr式Roux-en-Y 空肠食管吻合术组平均手术时间比P形空肠袢Roux-en-Y空肠食管吻合术组明显缩短(P＜0.05).结论 Orr式Roux-en-Y空肠食管吻合术是胃癌患者全胃切除术后较合适的消化道重建方式.

Comparative study on two Types of digestive Reconstruction after Total Gastrectomy in Patients with Gastric Carcinoma

Objective To compare the clinical value of two types of digestive recon-struction after total gastrectomy in patients with gastric carcinoma.Methods Orr-type Roux-en-Y esophagojejunostomy and P-type Roux-en-Y esophagojejunostomy were performed in 84 patients with gastric carcinoma after total gastrectomy.The operating time,postoperative complications and digestive tract symptoms were compared.Results There was no significant difference in postoperative digestive tract symptoms between two types(P>0.05).The postoperative complications in P-type Roux-en-Y esophagojejunostomywas a little bit more,but the difference was not significant(P>0.05).However,the operating time in Orr-type Roux-en-Y esophagojejunostomy was significantly shorter(P <0.05).Conclusion Orr-type Roux-en-Y esophagojejunostomy is a suitable type after total gastrectomy for patients with gastric carcinoma.