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胃癌全胃切除后不同消化道重建术式对消化吸收功能的影响 被引量:10

Effect of three various procedures of alimentary reconstruction after total gastrectomy on postoperative digestive and absorptive function
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摘要 目的探讨胃癌全胃切除术不同消化道重建方式对术后消化吸收功能的影响。方法对108例胃癌患者全胃切除后消化道重建方式分别采用常规食管空肠Roux-en-Y吻合术43例、P型空肠襻食管空肠Roux-en-Y吻合术41例和空肠贮袋食管空肠Roux-en-Y吻合术24例。观察术后3、12个月患者的营养状况和胃肠道症状GSPS评分等。结果术后3个月、12个月P型空肠襻组与常规组比较术后进食量增加P<0.01,而GSPS评分降低P<0.01,胃肠道症状发生几率降低。空肠贮袋组术后3个月、12个月进食量同样优于常规组P<0.01,GSPS评分降低P<0.01。且术后12个月P型空肠襻组与空肠贮袋组体重恢复较常规组更佳P<0.01。而术后12个月空肠贮袋组在患者进食量又优于P型空肠襻组P<0.01,体重恢复差异有统计学意义P<0.01。结论P型空肠襻和空肠贮袋食管空肠Roux-en-Y吻合术有利于维持患者术后的消化吸收功能,而行空肠贮袋在某些方面又优于P型空肠襻。 Objective To make comparative analysis about digestive and absorptive functions of patients receiving Roux-en-Y procedures of alimentary reconstruction after total gastreetomy. Methods The clinical data of 108 patients who underwent total gastreetomy with 3 Roux-en-Y procedures of alimentary reconstruction were analyzed retrospectively. Three procedures of the reconstruction including general Roux-en- Y esophagojejunostomy ( n = 43 ), P-type jejunal loop Roux-en-Y ( n = 41 ) and jejunal pouch Roux-en-Y (n = 24), were performed. Digestive and absorptive functions were assessed by gastrointestinal symptom rating scale (GSRS) , nutritional parameters, endoscopic examination were evaluated at 3, and 12 months after surgery. Results The procedures of P-type loop and jejunal pouch reconstruction provided better digestive and absorption functions than Roux-en-Y reconstruction in a short-term period ( at 3 and 12 months after operation), specially eating capacity and GSPS score (P 〈 0. 0 5 ). At 12 months after surgery, body weight recovery in the jejunal pouch group was significantly superior to that in the P-type loop group. Conclusions The procedures of P-type loop and jejunal pouch reconstruction may provide better digestive and absorption functions for patients undergoing total gastreetomy as compared with Roux-en-Y esophagojejunostomy. Jejunal pouch reconstruction provides further improvement of digestive and absorption functions in patients receiving total gastrectomy.
出处 《中华普外科手术学杂志(电子版)》 2008年第1期40-42,共3页 Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词 胃肿瘤 胃切除术 肠吸收 胃肠道重建 Stomach neoplasms Gastrectomy Intestinal absorption Gastrointestinal tract reconstruction
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参考文献11

  • 1曹学冬,王亚农.全胃切除术后消化道重建方式选择与评价[J].中国癌症杂志,2006,16(3):240-242. 被引量:19
  • 2Georgy Zherlov MD,Andrey Koshel MD,Yuliya Orlova,Dmitry Zykov,Sergey Sokolov,Nataliya Rudaya,Alexander Karpovitch.New Type of Jejunal Interposition Method after Gastrectomy[J].World Journal of Surgery.2006(8)
  • 3Yoshio Oka M.D.,Junichi Nishijima M.D.,Kunihiko Oku M.D.,Tatsuo Azuma M.D.,Keiji Inada M.D.,Satoru Miyazaki M.D.,Hiroshi Nakano M.D.,Yukihiro Nishida M.D.,Kazuya Sakata M.D.,Masaaki Izukura M.D.Usefulness of an Estimation of Physiologic Ability and Surgical Stress (E-PASS) Scoring System to Predict the Incidence of Postoperative Complications in Gastrointestinal Surgery[J].World Journal of Surgery.2005(8)
  • 4Shinya Adachi,Satoshi Inagawa,Tsuyoshi Enomoto,Eiji Shinozaki,Tatsuya Oda,Toru Kawamoto.Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures[J].Gastric Cancer.2003(1)
  • 5Adach i S,,Inagawa S,Enomoto T,et al.Sub jective and functional re-su lts after total gastrectomy:prospective study for longterm comparisonof reconstruction procedures[].Gastric Cancer.2003
  • 6Oka Y,Nishijima J,Oku K,et al.Usefulness of an estimation ofphysiologic ability and surgical stress(E-PASS)scoring system topredict the incidence of postoperative complications in gastrointes-tinal surgery[].World Journal of Surgery.2005
  • 7Zherlov G,Koshel A,Orlova Y,et al.New type of jejunal inter-position method after gastrectomy[].World Journal of Surgery.2006
  • 8Collard J M,Romagnoli R.Roux-en-y jejunal loop and bile reflux[].The American Journal of Surgery.2000
  • 9Kono K,Iizuka H,Sekikawa T,et al.Improved quality of life with jejunal pouch reconstruction after total gastrectomy[].The American Journal of Surgery.2003
  • 10Mochiki E,Kamiyama Y,Aihara R,et al.Postoperative function-al evaluation of jejunal interposition with or without a pouch after a total gastrectomy for gastric cancer[].The American Journal of Surgery.2004

二级参考文献17

  • 1Bengt L.Symptoms after total gastrectomy on food intake,body composition,bone metabolism,and quality of life in gastric cancer patients:is reconstruction with a reservoir worthwhile[J].Nutrition,1999,15(9):677-682.
  • 2Nakane Y,Okumura S,Akehira K,et al.Jejunal pouch reconstructionafter total gastrectomy for cancer.A randomized controlled trial[J].Annals of Surgery,1995,222(1):27-35.
  • 3Chin Anthony C,Espat NJ.Total gastrectomy:options for the restoration of gastrointestinal continuity[J].Lancet Oncol,2003,4(5),p271.
  • 4Andreas S,Markus B,Kerstin U.et.al.Importance of the duodenal passage and pouch volume after total gastrectomyand reconstruction with the ulm pouch:prospective randomized clinical study[J].World J.Surg,1996,20(1):60-67.
  • 5Makoto T,Yoshinobu S,Jiro N.Quantitative evaluation of reconstruction methods after gastrectomy using a new type of examination:digestion and absorption test with stable isotope 13C-labeled lipid compound[J].Gastric Cancer,2003,6(3):134-141.
  • 6Shinya A,Satoshi I,Tsuyoshi E.et al.Subjective and functional results after total gastrectomy:prospective study for long term comparison of reconstruction procedures[J].Gastric Cancer,2003,6(1):24-29.
  • 7Nakane 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].Hepato-Gastroenterology,2001,48(39):903-907.
  • 8Fuchs KH.Thiede A.Reconstruction of the food passage after total gastrectomy:randomized trial[J].World Surgery,1995,19(5):698-705;discussion 705-706.
  • 9Koji K,Hidehiko I,Takayoshi S.et al.Improved quality of life with jejunal pouch reconstruction after total gastrectomy[J].Am Surgery,2003,185(2):150-154.
  • 10Mauri K,Iivonen,Matti O.Emptying of the jejunal pouch and roux-en-Y limb after total gastrectomy-a randomised,prospective study[J].Eur J Surg,1999,165(8):742-747.

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