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目的探讨全胃切除术后较理想的消化道重建方式。方法对近6年来1 2 2例施行全胃切除术患者的临床资料进行回顾性分析。全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。结果3种术式在食后烧灼感、进食量、进食次数、体重下降、倾倒综合征、血红蛋白、白蛋白等指标的比较,无明显差异(均P>0.0 5)。P型空肠袢食管空肠Roux-en-Y吻合术组所用手术时间显著多于Orr组及反口组(P<0.0 5)。反口组的贮袋大小及半排空时间显著优于Orr组及P袢组(P<0.0 5)。结论远端空肠反口贮袋的Roux-en-Y吻合术是一种值得推荐的新型全胃切除术后消化道重建方法。
Objective To investigate the ideal method of digestive tract reconstruction after total gastrectomy. Methods The clinical data of 122 cases of total gastrectomy in the past 6 years were analyzed retrospectively. Total gastrectomy digestive tract reconstruction were performed after total gastrectomy reconstruction Orr Roux-en-Y esophagojejunostomy, P-type jejunum Esophageal Roux-en-Y anastomosis and distal jejunal anti-mouth pocket Roux-en-Y esophagojejunostomy. Results There was no significant difference in the burning sensation, food intake, food intake, weight loss, dumping syndrome, hemoglobin and albumin in the three kinds of operation (P> 0.05). The operation time of Roux-en-Y anastomosis group in P-type jejunum was significantly higher than that in Orr group and trans-oral group (P <0.05). The size and half-emptying time of the reverse osmosis group were significantly better than Orr group and P group (P <0.05). Conclusions Roux-en-Y anastomosis of far-end jejunum with anti-mouth pocket is a recommendable new method of digestive tract reconstruction after total gastrectomy.