根治性远端胃大部切除带蒂回盲肠间置代幽门术的临床应用

摘要

Objechve:To explore the clinical application of pedicled ileocecum interposition graft as pylorus replacement for subtotal distal gastrectomy.Methods : From 1992 to 2004, 58 cases of sinus ventriculi cancer received subtotal distal gastrectomy were randonuzed into two methods of digestive reconstruction, including pedicled ileocecum interposition graft as pylorus replacement digestive reconstruction ( Study group, 26 cases) and Billroth Ⅱ anastomosis digestive reconstruction ( Control group, 32 cases).The stomach volume,gastnc empting time, incidence rate of bile regurgitation, incidence rate of gastric mucosa hyperemia inflammation, and weight changing were compared in 6 months after operation.The recurrence rate of cancer and recurrence time after operation were also inveatigated in 5years after operation.Results: Compared to control group, the stomach volume increased, the gastric empting time was prolonged, and the incidence rate of bile regurgitation and gastic mucosa hyperemia inflammation decreased.And the recurrence rate of cancer decreased, recurrence time after operation was prolonged in study group.Condusion:Pedicled ileocecum interposition graft as pylorus replacement is an ideal digestive reconstruction after radical distal subtotal gastrectomy.%目的:探讨根治性远端胃大部切除带蒂回盲肠间置代幽门术治疗胃癌的临床应用价值.方法:1992年-2004年对58例胃窦癌行根治性远端胃大部分切除后随机采用两种消化道重建术式,带蒂回盲肠间置代幽门术重建消化道组26例(研究组),BillrothⅡ式吻合术重建消化道组32例(对照组).术后6个月对胃存贮量、胃排空时间、胆汁反流的发生率、胃黏膜充血炎症的发生率,体重变化及术后5年内胃癌复发率及复发时间进行比较分析.结果:与对照组相比,研究组的胃存贮量增加、胃排空时间延长,胆汁反流、胃黏膜充血炎症的发生率降低,体重增加明显,术后5年内的复发率减低,术后复发时间延长.结论:带蒂回盲肠间置代幽门术是胃窦癌患者根治性远端胃大部切除后的较为理想的消化道重建方式.