全胃切除消化道重建术式的比较

目的：探讨全胃切除后消化道重建的最佳术式。方法：对148例胃癌行全胃切除病例进行回顾性分析。结果：Roux-en-Y吻合术25例、空肠袋加Roux-en-Y吻合术30例、间置空肠代胃术23例、空肠袋加间置空肠代胃术22例、功能性间置空肠代胃术48例;功能性间置空肠代胃术术后并发症发生率10.4%,优于其他各组44%,26.7%,34.7%,22.7%,10.4%;Visick分级Ⅰ级Ⅱ级百分比为77.1%,优于其他各组48.0%,46.7%,52.2%,45.5%;在手术时间、术后生存率及体重变化方面无明显差异。结论：功能性间置空肠代胃术可以有效减少术后并发症的出现,且手术操作安全简便,在各方面都相对于另外四种术式更有优势。

Comparison of methods of total gastrectomy accompanied by digestive tract recon struction

Objective：To discuss the best method of digestive tract reconstruction after total gastrectomy.Methods： Total of 148 patients of total gastrectomy were reviewed respectively.Results： Of all the patients,Roux-en-Y anastomosis was performed in 25 cases,Roux-en-Y anastomosis accompanying by Jejunum bag in 30 cases,reconstruction of stomach with jejunum in 23 cases,reconstruction of stomach with jejunum accompanying by Jejunum bag in 22 cases,functional reconstruction of stomach with jejunum accompanying by Jejunum bag in 48 cases.It could be observed that the rate of postoperative complications of functional reconstruction of stomach with jejunum was 10.4%,better than other groups,which were 44%,26.7%,34.7%,22.7%,10.4% respectively.The rate of first level and second level of Visick levels was 77.1%,better than other groups,which were 48.0%,46.7%,52.2%,45.5% respectively.There were no significant differences in operating time,postoperative survival rate,change of weight.Conclusion： The method of functional reconstruction of stomach with jejunum could apparently decrease the postoperative complications of all methods adopted in surgeries,besides,the process is not only security,but also convenient.