改良间置空肠食管残胃吻合在贲门癌切除术18例中的应用

目的:探讨早期贲门癌切除术的消化道重建方式。方法:总结高邮市人民医院2003年10月～2005年10月间采用经腹早期贲门癌根治性近侧胃大部切除,改良间置空肠食管残胃吻合术18例患者的临床资料。结果:无1例手术死亡,无吻合口瘘及狭窄,全组均痊愈出院。术后随访1个月至2年,平均11.3个月,无反流性食管炎、排空障碍及倾倒综合征,术后3个月进食量每餐400￣500 g,每日进餐3￣4次,术后6个月患者无贫血,体重接近或超过术前水平。结论:早期贲门癌行根治性近侧胃大部切除,采用改良间置空肠食管残胃吻合术能有效提高患者术后生活质量。

Application of the proximal gastrectomy for reconstruction of digestive tract with improved interposition of jejunum

Objective: To find out the methods for the reconstruction of digestive tract following proximal gastrectomy.Methods: The clinical data of 18 patients with cardia carcinoma undergoing transabdominal proximal gastrectomy for the reconstruction of digestive tract with improved interposition of jejunum from October 2003 to October 2005 were analyzed retrospectively.Results: No death,no stoma fistula,nor constriction were present after operation.All patients were discharged after recovery.Follow-up survey was performed for 1 month to 2 years,and no bile reflux,empty disorder and dumping syndrome were found.Three months later,patients could take about 400-500 g food at each meal(3 or 4 times a day).Six months later,no anemia was found,and their body weight approached or exceeded to the preoperative level.Conclusion: The reconstruction of digestive tract after proximal gastrectomy using improved interposition of jejunum can improve the quality of patients' postopertive life.