• 吉林大學(xué)中日聯(lián)誼醫(yī)院胃腸外科(長春 130033);

目的  探討改良Orr式Roux-en-Y食管空腸吻合術(shù)的臨床應(yīng)用價值。方法  胃癌行全胃切除術(shù)患者共38例,消化道重建按手術(shù)日期隨機(jī)分為ρ型食管空腸吻合組(ρ型組)20例及改良Orr式Roux-en-Y 食管空腸吻合組(改良組)18例。比較2組的手術(shù)時間、術(shù)中出血量、術(shù)后并發(fā)癥發(fā)生率、貯袋排空時間和術(shù)前及術(shù)后3個月時的體重變化情況。結(jié)果  改良組和ρ型組的手術(shù)時間分別為(229±18) min和(283±35) min(P<0.05); 貯袋全排空時間分別為(35.7±4.9) min 和(3.0±0.5) min(P<0.01)。在術(shù)中出血量、術(shù)后并發(fā)癥發(fā)生率和體重變化方面,2組間差異無統(tǒng)計(jì)學(xué)意義(P gt;0.05)。結(jié)論  改良Orr式Roux-en-Y食管空腸吻合術(shù)有利于操作,可節(jié)省手術(shù)時間,有一定貯袋功能,不增加并發(fā)癥,有臨床應(yīng)用價值。

引用本文: 孫立波,李永超,馮野,舒振波,丁大勇,金殷植,趙吉生,鄭澤霖. 全胃切除術(shù)后改良Orr式Roux-en-Y 食管空腸吻合術(shù)的臨床研究. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(12): 917-919. doi: 復(fù)制

1. 詹文華. 循證醫(yī)學(xué)和全胃切除后消化道重建 [J]. 中國實(shí)用外科雜志, 2004; 24(9)∶ 514.
2. 季加孚. 全胃切除后的消化道重建 [J]. 中國實(shí)用外科雜志, 2004; 24(9)∶ 516.
3. Lehnert T, Buhl K. Techniques of reconstruction after total gastrectomy for cancer [J]. Br J Surg, 2004; 91(5)∶ 528.
4. 朱正綱. 全胃切除與消化道重建術(shù)在胃癌治療中的臨床意義 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(1)∶15.
5. 肖仕明, 姜淮蕪, 陳 進(jìn), 等. 全胃切除調(diào)節(jié)型雙通道間置空腸消化道重建 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(1)∶23.
6. Ogoshi K, Okamoto Y, Nabeshima K, et al. Focus on the conditions and resection and reconstruction in gastric cancer. What extent of resection and what kind of reconstruction provided the best outcome for gastric caner patients? [J]. Digestion, 2005; 71(4)∶ 213.
7. 劉作金, 劉長安, 龔建平, 等. 間置空腸代胃與Roux-en-Y吻合法消化道重建對病人生存質(zhì)量影響的研究 [J]. 中國實(shí)用外科雜志, 2005; 25(7)∶420.
8. 夏 焱, 姜波健, 韓肖華, 等. 胃癌患者全胃切除術(shù)后空腸代胃消化道重建術(shù)式的對比研究 [J]. 中華胃腸外科雜志, 2004; 7(1)∶ 24.
9. Nakane Y, Michiura T, Inoue K, et al. A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition? [J]. Hepatogastroenterology, 2001; 48(39)∶ 903.
10. Mochiki E, Kamiyama Y, Aihara R, et al. Postoperative functional evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer [J]. Am J Surg, 2004; 187(6)∶ 728.
11. Nozoe T, Anai H, Sugimachi K. Usefulness of reconstruction with jejunal pouch in total gastrectomy for gastric cancer in early improvement of nutritional condition [J]. Am J Surg, 2001; 181(3)∶ 274.
12. 衛(wèi)洪波, 魏 波, 鄭宗珩, 等. 全胃切除后三種消化道重建術(shù)式的比較研究 [J]. 中華胃腸外科雜志, 2006; 9(4)∶ 301.
13. Kono K, Iizuka H, Sekikawa T, et al. Improved quality of life with jejunal pouch reconstruction after total gastrectomy [J]. Am J Surg, 2003; 185(2)∶150.
14. Adachi S, Inagawa S, Enomoto T, et al. Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures [J]. Gastric Cancer, 2003; 6(1)∶ 24.
15. 黃祥成, 巴明成, 卿三華, 等. 全胃切除后三種消化道重建術(shù)式對生活質(zhì)量的影響 [J]. 中華普通外科雜志, 2005; 20(10)∶ 654.
16. 支 珍. 全胃切除術(shù)后消化道重建兩種術(shù)式的臨床觀察 [J]. 中國普通外科雜志, 2007; 16(9)∶ 875.
17. 葉再元, 張 勤, 余建法, 等. 連續(xù)性空腸間置在胃次全切除術(shù)消化道重建中的應(yīng)用研究 [J]. 中華胃腸外科雜志, 2006; 9(3)∶ 238.
18. Fein M, Fuchs KH, Thalheimer A, et al. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a randomized trial [J]. Ann Surg, 2008; 247(5)∶ 759.
19. 伍韶斌, 陳志康, 陳晉湘, 等. 胃癌全胃切除術(shù)后消化道重建方式的選擇 [J]. 中國普通外科雜志, 2006; 15(10)∶ 766.
20. Kalmár K, Cseke L, Zámbó K, et al. Comparison of quality of life and nutritional parameters after total gastrectomy and a new type of pouch construction with simple Roux-en-Y reconstruction: preliminary results of a prospective, randomized, controlled study [J]. Dig Dis Sci, 2001; 46(8)∶1791.
21. 曾玉劍, 程 中, 周總光. 全胃切除后消化道重建的現(xiàn)狀 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(5)∶ 383.
  1. 1. 詹文華. 循證醫(yī)學(xué)和全胃切除后消化道重建 [J]. 中國實(shí)用外科雜志, 2004; 24(9)∶ 514.
  2. 2. 季加孚. 全胃切除后的消化道重建 [J]. 中國實(shí)用外科雜志, 2004; 24(9)∶ 516.
  3. 3. Lehnert T, Buhl K. Techniques of reconstruction after total gastrectomy for cancer [J]. Br J Surg, 2004; 91(5)∶ 528.
  4. 4. 朱正綱. 全胃切除與消化道重建術(shù)在胃癌治療中的臨床意義 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(1)∶15.
  5. 5. 肖仕明, 姜淮蕪, 陳 進(jìn), 等. 全胃切除調(diào)節(jié)型雙通道間置空腸消化道重建 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(1)∶23.
  6. 6. Ogoshi K, Okamoto Y, Nabeshima K, et al. Focus on the conditions and resection and reconstruction in gastric cancer. What extent of resection and what kind of reconstruction provided the best outcome for gastric caner patients? [J]. Digestion, 2005; 71(4)∶ 213.
  7. 7. 劉作金, 劉長安, 龔建平, 等. 間置空腸代胃與Roux-en-Y吻合法消化道重建對病人生存質(zhì)量影響的研究 [J]. 中國實(shí)用外科雜志, 2005; 25(7)∶420.
  8. 8. 夏 焱, 姜波健, 韓肖華, 等. 胃癌患者全胃切除術(shù)后空腸代胃消化道重建術(shù)式的對比研究 [J]. 中華胃腸外科雜志, 2004; 7(1)∶ 24.
  9. 9. Nakane Y, Michiura T, Inoue K, et al. A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition? [J]. Hepatogastroenterology, 2001; 48(39)∶ 903.
  10. 10. Mochiki E, Kamiyama Y, Aihara R, et al. Postoperative functional evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer [J]. Am J Surg, 2004; 187(6)∶ 728.
  11. 11. Nozoe T, Anai H, Sugimachi K. Usefulness of reconstruction with jejunal pouch in total gastrectomy for gastric cancer in early improvement of nutritional condition [J]. Am J Surg, 2001; 181(3)∶ 274.
  12. 12. 衛(wèi)洪波, 魏 波, 鄭宗珩, 等. 全胃切除后三種消化道重建術(shù)式的比較研究 [J]. 中華胃腸外科雜志, 2006; 9(4)∶ 301.
  13. 13. Kono K, Iizuka H, Sekikawa T, et al. Improved quality of life with jejunal pouch reconstruction after total gastrectomy [J]. Am J Surg, 2003; 185(2)∶150.
  14. 14. Adachi S, Inagawa S, Enomoto T, et al. Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures [J]. Gastric Cancer, 2003; 6(1)∶ 24.
  15. 15. 黃祥成, 巴明成, 卿三華, 等. 全胃切除后三種消化道重建術(shù)式對生活質(zhì)量的影響 [J]. 中華普通外科雜志, 2005; 20(10)∶ 654.
  16. 16. 支 珍. 全胃切除術(shù)后消化道重建兩種術(shù)式的臨床觀察 [J]. 中國普通外科雜志, 2007; 16(9)∶ 875.
  17. 17. 葉再元, 張 勤, 余建法, 等. 連續(xù)性空腸間置在胃次全切除術(shù)消化道重建中的應(yīng)用研究 [J]. 中華胃腸外科雜志, 2006; 9(3)∶ 238.
  18. 18. Fein M, Fuchs KH, Thalheimer A, et al. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a randomized trial [J]. Ann Surg, 2008; 247(5)∶ 759.
  19. 19. 伍韶斌, 陳志康, 陳晉湘, 等. 胃癌全胃切除術(shù)后消化道重建方式的選擇 [J]. 中國普通外科雜志, 2006; 15(10)∶ 766.
  20. 20. Kalmár K, Cseke L, Zámbó K, et al. Comparison of quality of life and nutritional parameters after total gastrectomy and a new type of pouch construction with simple Roux-en-Y reconstruction: preliminary results of a prospective, randomized, controlled study [J]. Dig Dis Sci, 2001; 46(8)∶1791.
  21. 21. 曾玉劍, 程 中, 周總光. 全胃切除后消化道重建的現(xiàn)狀 [J]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(5)∶ 383.