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报告6例贲门胃底癌及胃体上部癌行根治性全胃切除,保留幽门问置空肠代胃术的临床效果。选择5、6组淋巴结无转移,不影响根治效果的6例病人,行保留幽门全胃切除术后,将25cm空肠间置于食管与十二指肠之间。术后通过临床观察,上消化道锁餐X线摄片、电子纤维胃镜检查及食管、问五空肠活检等证明此术式有良好的抗返流作用,并延长了食物在“代胃”内停留时间,幽门录作用正常。术后3个月、半年、1年钡餐摄片观察代胃扩张,幽门开放功能良好,无返流现象;术后半年、1年、2年电子胃镜检查并活检,无返流性食管炎发生。生存期与同期不保留幽门间置空肠代胃术相比,无显著性差异。
Six cases of gastric cardia cancer and upper body cancer were treated with radical total gastrectomy, and the clinical effects of pyloric and jejunal gastrostomy were reserved. 6 patients with no lymph node metastasis and 5 or 6 lymph node metastasis were selected. After pylorus gastrectomy was performed, 25 cm jejunum was placed between the esophagus and duodenum. After clinical observation, upper gastrointestinal tract meal X-ray radiograph, electronic fiber endoscopy and esophageal, asked five jejunum biopsy proved that this method has a good anti-reflux effect, and extended food in the “stomach” For the duration of stay, the pylorus record was normal. 3 months, six months, and one year after the observation of the barium meal to observe the expansion of the stomach, pylorus opening function is good, no reflux phenomenon; postoperative six months, one year, two years of electronic gastroscopy and biopsy, no reflux esophagitis occurred . There was no significant difference between the survival time and the period of jejunal jejunal gastrojejunostomy.