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目的 探讨理想的全胃切除术后消化道重建方式。方法 对 1995～ 1999年经病理证实行全胃切除术胃癌 2 35例进行回顾性分析。其中 ,功能性间置空肠代胃术 (FJI) 78例 (33 .2 % ) ,“P”型Roux -en -Y空肠代胃术 (PR) 15 7例 (6 6 .8% )。随访 2年 ,比较其术后的并发症、Visick指数、体重变化。结果 89%的FJI术后病人的Visick指数为Ⅰ -Ⅱ ;PR的Roux -en -Y滞留综合征 (RSS)发生率为 42 .7%。倾倒综合征、返流性食管炎分别为 16 .7%、2 6 .5 %。结论 FJI保持了重建消化道神经 -肌肉功能的连续性 ,恢复食物经过十二指肠通道 ,对于减少全胃术的并发症、提高生存质量有重要意义 ,是全胃切除术后理想的消化道重建术式。
Objective To investigate the ideal way of digestive tract reconstruction after total gastrectomy. Methods A retrospective analysis of 2 35 cases of gastric cancer with total gastrectomy performed from 1995 to 1999 was performed. Among them, there were 78 cases (33. 2%) with functional interstitial gastrojejunostomy (FJI), 157 cases (6 6 .8%) of “P” Roux-en-Y jejunal gastrectomy (PR). After 2 years of follow-up, their postoperative complications, Visick index, and weight change were compared. Results Visick index was I - II in 89% of FJI patients; the incidence of Roux-en-Y retention syndrome (RSS) in PR was 42.7%. Dumping syndrome and reflux esophagitis were 16.7% and 26.5%, respectively. Conclusions FJI maintains the continuity of the function of reconstructing the digestive tract nerve-muscle function and restores the passage of food through the duodenal passage. It is of great significance in reducing the complications of total gastrectomy and improving the quality of life. It is an ideal digestive tract after total gastrectomy. Reconstruction surgery.