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目的:探讨胃癌患者全胃切除消化道重建的治疗经验。方法:分析7例胃癌行全胃切除双Braun吻合空肠代胃术患者的临床资料。结果:平均手术时间为(4.2±0.3)h,平均失血量(380±45)mL;术后肛门排气时间平均68.3 h,术后平均75 h开始进食全流饮食,住院时间平均18 d;围术期无严重并发症发生,1例(14.29%)出现肺部感染,1例(14.29%)出现切口液化;均顺利出院。术后随访3~36个月,未出现倾倒综合征及明显的营养不良;1例复发。总体疗效良好。结论:胃癌患者行全胃切除双Braun吻合空肠代胃术可以提高患者术后的生活质量,降低术后并发症及病死率,是一种较为安全和理想的胃肠道重建方式。
Objective: To investigate the therapeutic experience of total gastrectomy and digestive tract reconstruction in patients with gastric cancer. Methods: The clinical data of 7 patients with gastric cancer who undergone total gastrectomy and double Braun anastomosis on behalf of stomach surgery were analyzed. Results The mean operative time was (4.2 ± 0.3) h and mean blood loss was (380 ± 45) mL. The average time of postoperative anal exhaust was 68.3 hours, and the mean flow time was 75 hours. The average length of hospital stay was 18 days. No serious complications occurred during the perioperative period. One patient (14.29%) developed pulmonary infection and one patient (14.29%) had incisional liquefaction. All patients were discharged smoothly. The patients were followed up for 3 to 36 months without dumping syndrome and obvious malnutrition. One patient recurred. The overall effect is good. Conclusions: Total gastrectomy with double Braun anastomosis and jejunum replacer can improve postoperative quality of life and reduce postoperative complications and mortality, which is a safe and ideal method of gastrointestinal tract reconstruction.