全胃切除消化道重建术中空肠储袋的临床研究进展

全胃切除术是常见的胃癌根治术之一。尽管消化道重建的方式繁多，但何种最好尚无定论。经检索近年来有关全胃切除后的消化道重建临床研究报道，主要介绍不同空肠肠袋、Roux-en-Y重建术式的优劣。结果表明，空肠肠袋、Roux—en—Y重建术式并不显著增加手术病死率和并发症发生率，能够改善术后早期食物摄入和体重增加。多数报道认为有利于提高术后生活质量。肠袋重建并未增加手术的风险，而且在早期能改善食物摄入，增加体重，有利于患者术后恢复，一定程度上提高患者生活质量。而患者术后长期效果，由于其影响因素涉及范围广，如地区差异和经济条件等，故要得出一精确结论还有待于进一步的探索。现就非十二指肠径路的主要方式及效果作一简述。

Application of jejunal pouch as reconstruction after total gastrectomy

Total gastrectomy is one of radical resections for gastric cancer. Although various modifications to restore alimentary tract continuity after total gastrectomy have been described, there is no general agreement with regard to the ideal reconstruction. In this review, we discussed the jejunal pouch reconstruction, but not restoration of duodenal passage. The literatures were on clinical trials comparing reconstructive procedures after total gastrectomy for malignancy, and they hand reported different types of jejunal pouches and the Roux-en-Y reconstruction. The reconstructions did not significantly increase operative mortality and procedure-related complications,and were associated with improved food intake and a tendency for weight gain in the early postoperative months. A favourable perception of quality of life persisted after operation in some studies. Construction of a small-bowel reservoir after total gastrectomy did not increase the operative risk, while should be considered to improve early postoperative eating capacity, bodyweight and quality of life to a certain extent. Nevertheless, the impact factors involved postoperative long term benefits are diversified, such as the differences of regions or economic conditions, so further studies are necessary to give an accurate evaluation.