中国实用外科杂志

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根治性全胃切除改良双贮袋Roux-en-Y吻合消化道重建临床效果研究

赵玉洲韩广森任莹坤鲁朝敏顾焱晖王刚成马鹏飞   

  1. 河南省肿瘤医院,河南郑州450003
  • 发布日期:2012-01-18

  • Published:2012-01-18

摘要:

目的    介绍一种全胃切除术改良双贮袋Roux-en-Y吻合消化道重建方式,并与传统袢式吻合和Roux-en-Y吻合的中短期效果进行对比研究。 方法    2008年5月至2010年3月河南省肿瘤医院普外科将106例因胃癌行根治性全胃切除术病人,随机分为3组分别接受改良双贮袋Roux-en-Y吻合、袢式吻合和Roux-en-Y吻合3种空肠代胃手术方式。比较3组病人的手术时间、术后并发症、住院总费用和住院时间。并于术后1、6、12个月分别进行胃癌病人生活质量调查问卷(QLQ-STO 22)评分。 结果    改良双贮袋Roux-en-Y吻合在手术时间、术后并发症、住院总费用、住院时间等方面与其他两组比较差异无统计学意义。但生活质量评估(吞咽困难、疼痛、呃逆和饮食受限)明显优于其他两组。 结论    改良双贮袋Roux-en-Y吻合具有安全、术后生活质量高等优点。

关键词: 胃癌, 食管空肠吻合术

Abstract:

Clinical effect research of modified double pouch Roux-en-Y reconstruction after radical total gastrectomy             ZHAO Yu-zhou,HAN Guang-sen,REN Ying-kun,et al. Henan Tumor Hospital,Zhengzhou 450003,China
Corresponding author:HAN Guang-sen,E-mail:hnhanguangsen@126.com
Abstract    Objective    To introduce a new method of reconstruction of the gastrointestinal tract in radical total gastrectomy, and compare the effects with loop and Roux-en-Y anastomosis. Methods    From May 2008 to March 2010, 106 patients who underwent radical total gastrectomy for gastric cancer in Department of General Surgery of Henan Tumor Hospital were randomly divided into 3 groups:Modified double pouch Roux-en-Y group, loop group and Roux-en-Y group. The operation time, postoperative complications, hospital expenses and hospital stay in the 3 groups were compared. The Quality of Life Questionnaire of Stomach 22 was analyzed in 1, 6 and 12 months after operation respectively. Results    There was no significant difference between modified double pouch Roux-en-Y group and other two groups in operation time, postoperative complication, hospital expenses and hospital stay. The modified double pouch Roux-en-Y group showed a better score in dysphagia, pain, hiccup and drink and food limitation than other two groups. Conclusion    The modified double pouch Roux-en-Y method is a safe method of reconstruction of the gastrointestinal tract and has a better quality of life.

Key words: stomach tumor, esophagojejunostomy