CAJ | 학술논문

目的探讨腹腔镜胃上部癌根治术残胃空肠双通道重建的价值.方法对25例胃上部癌患者行腹腔镜近端胃大部根治性切除,保留远端残胃,行空肠残胃侧侧吻合、空肠空肠端侧吻合的双通道消化道罩=建术.结果手术平均时间(240±35)min,切缘阴性,平均清扫淋巴结(22±5)枚,无吻合口漏及狭窄、梗阻等并发症.术后均行钡餐造影,显示大部分钡剂直接进入空肠,少部分经过残胃.十二指肠进入空肠,并在残胃中滞留30～60min,无钡剂反流入食管.随访4～18个月,患者无明显反流性食管炎表现,近期生活质量满意.结论残胃空肠双通道重建术清扫、切除范围合理,残胃有一定储袋作用,能较好地预防反流性食管炎和倾倒综合征;保留了十二指肠径路,提高了患者生活质量,是胃上部癌根治术较理想的消化道重建方式.
목적 탐토복강경위상부암근치술잔위공장쌍통도중건적개치.방법 대25례위상부암환자행복강경근단위대부근치성절제,보류원단잔위,행공장잔위측측문합、공장공장단측문합적쌍통도소화도조=건술.결과 수술평균시간(240±35)min,절연음성,평균청소림파결(22±5)매,무문합구루급협착、경조등병발증.술후균행패찬조영,현시대부분패제직접진입공장,소부분경과잔위.십이지장진입공장,병재잔위중체류30～60min,무패제반류입식관.수방4～18개월,환자무명현반류성식관염표현,근기생활질량만의.결론 잔위공장쌍통도중건술청소、절제범위합리,잔위유일정저대작용,능교호지예방반류성식관염화경도종합정;보류료십이지장경로,제고료환자생활질량,시위상부암근치술교이상적소화도중건방식.
Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.