全胃切除围巾式食管-空肠吻合术在进展期胃癌中的应用

目的总结围巾式食管．空肠吻合术预防进展期胃癌全胃切除术后吻合口瘘的临床经验。方法分析2000年1月至2008年10月连续86例进展期胃癌全胃切除围巾式食管-空肠吻合术的临床效果。结果本组手术病死率为2．3％（2／86）。存活84例均获随访，随访时间2～95个月，平均（44±3）个月，术后均未发生吻合口瘘和反流性食管炎，2004年12月及以前，有4例（4．8％，4／84）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

Objective To present the experience with scarf-liking esophagojejunal anastomosis to decrease the anastomotic leak. Methods An analysis of the clinical outcome of 86 consecutive patients from January 2000 to October 2008 who underwent scarf-liking esophagojejunal anastomosis after total gastrectomy for advanced gastric carcinoma. Results Two of these patients died, the operative mortality rate was 2.3 %. Eighty-four survivals were followed up for 2-95 （44 ± 3 ） months. None of the survivals developed anastomotic leak and reflux esophagitis. Anastomotic strictures occurred in 4 patients （4.8 % ） treated before December 2004, and transgastroscopy dilatation was effective treatment. There was no anastomotic stricture developed after surgical technology improved. Conclusion The new scarf-liking esophagojejunal anastomosis has more advantages to reduce anastomotic complications and total gastrectomy for advanced gastric carcinoma, is safe and effective.