进展期胃癌全胃切除"围巾式"食管-空肠吻合术(附121例报告)

目的 介绍“围巾式”食管-空肠吻合术预防术后吻合口瘘的临床经验。方法 分析1997年1月至2005年12月连续121例进展期胃癌全胃切除“围巾式”食管-空肠吻合术的临床结果。结果 手术死亡率1．65％（2／121）。存活的119例中，术后均未发生吻合口瘘和反流性食管炎。2000年12月以前，有4例（3．36％）术后发生吻合口狭窄，经胃镜下扩张治愈；改进技术后再无吻合口狭窄发生。结论 “围巾式”食管-空肠吻合术可减少进展期胃癌全胃切除术后吻合口并发症，安全、有效。

Scarf- liking esophagojejunal anastomosis after total gastrectomy for advanced gastric carcinoma :a report of 121 cases

Objective To present our experience with scarf-liking esophagojejunal anastomosis to decrease the anastomotic leak.Methods An analysis of the clinical outcome of 121 consecutive patients from January 1997 to December 2005,who underwent scarf-liking esophagojejunal anastomosis after total gastrectomy for advanced gastric carcinoma.Results Two of these patients died,the operative mortality rate was 1.65%.None of the survivals developed anastomotic leak and reflux esophagitis.Anastomotic strictures occurred in four patients (3.36%) treated before December 2000,and transgastroscopy dilatation was effective treatment.There's no anastomotic stricture developed after surgical technology improved.Conclusion The new scarf-liking esophagojejunal anastomosis has more advantages to reduce anastomotic complications after total gastrectomy for advanced gastric carcinoma,is safe and effective.