摘要
肿瘤切除、淋巴结清扫和消化道重建是胃癌根治术三大步骤，其中消化道重建对减少术后并发症和维持较好的生命质姑至关重要。非离断式Roux-ell-Y吻合术是在BillrothⅡ式＋Braun吻合术基础上，闭合而不离断近端空肠的改良重建手术方式，目的是减少滞留综合征的发生。与传统Roux-en-Y吻合术比较，非离断式Roux-en-Y吻合术不仅保留r减少N3t-和胰液反流的优势，还可减少因阻断空肠机电传导而引起的一系列并发症。由于早期基础研究中，闭合口存在较高的裂开和再通发生率，故其在临床上并未普及。近年来，由于闭合技术的优化，非离断式Roux-en-Y吻合术在远端胃切除术中应用越来越广泛，并可能成为最佳的消化道重建方式。
Digestive tract reconstruction is an important part of gastric carcinoma operation as well as tmnor resection and lymph node dissection. Surgeons are seeking the optimal recon- struction method that reduces the occurrence of complications and maintains better quality of postoperative life extremely. Uncut Roux-en-Y anastomosis is a modified procedure in which an arti- fieial jejunal occlusion is devised to avoid Roux stasis syndrome based on Billroth II and Braun＇s anastomosis. Compared to the conventional Roux-en-Y anastomosis, the uncut Roux-en-Y anastonmsis retains the advantage of preventing biliary and pan- creatie secretions reflux, furthermore, it can decrease the symp- toms associated with Roux stasis owing to the abnormal myoelec- trical conduction of Roux limb. Because the early studies indica- ted that there was higher incidence of dehiscence or recanaliza- tion of the jejunal occlusion, the uncut Roux-en-Y anastomosis has not been widely applied. Since jejunal occlusion has been optimized recently, the uncut Roux-en-Y reconstruction may be an optional and appropriate method of digestive tract reconstruc- tion after distal gastrectomy.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2016年第9期943-946,共4页
Chinese Journal of Digestive Surgery
