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1、中国普外基础与临床杂志2008年1月第15卷第1期ChinJBasesClinGeneralSurg,Vol.15,No.1,Jan.2008·23·【文章编号】1007-9424(2008)01-0023-04胃癌·临床研究全胃切除调节型双通道间置空肠消化道重建333333肖仕明姜淮芜陈进肖平郭海燕孙燕【摘要】目的介绍一种新的全胃切除消化道重建术。方法选取我院2004年6月至2006年3月期间行全胃切除病例38例。在行消化道重建时,对功能性空肠间置代胃(FJI)术作如下改良:将输出袢适度丝线结扎改为部分缩窄缝合2～3针,适当缩短输入袢肠管至20～25cm,Braun吻合
2、口距Treitz韧带10cm,以食管空肠及Braun吻合口无张力为度。结果全组病例无围手术期死亡、吻合口漏及倾倒综合征发生。Roux2en2Y滞留综合征2例;返流性食管炎1例;Visick分级:35例Ⅰ级,3例Ⅱ级。血清营养学指标:仅2例血红蛋白低于正常。术后6个月,36例进食量和体重恢复术前水平,仅2例体重下降。造影钡剂主要进入十二指肠通道,少量通过部分缩窄通道。结论对FJI重建术的改良,不仅保留了原法的全部优点,而且可进一步降低并发症,改善患者生活质量,但需进行进一步的前瞻性对比研究。【关键词】功能性空肠间置代胃术改良全胃切除消化道重建【中图分类号】R656.61∶R
3、735.2【文献标识码】ANewDoubleTractDigestiveReconstructionofTotalGastrectomy:TheModifiedFunctionalJejunalInterposition3333333XIAOShi2ming,JIANGHuai2wu,CHENJin,XIAOPing,GUOHai2yan,SUNYan.TheSecondDepartmentofGeneralSurgery,TheSecondAffiliatedHospitalofNorthernSichuanMedicalCollege,Mianyang621000,C
4、hinaCorrespondingAuthor:JIANGHuai2wu,E2mail:Jhuaiwu@yahoo.com.cn【Abstract】ObjectiveTodescribeanewtechniquefordigestivetractreconstructionoftotalgastrectomy.MethodsThemodifiedfunctionaljejunalinterposition(FJI)wasperformedin38patientswhounderwenttotalgas2trectomybetweenJune2004andMarch2006
5、.Atdigestivetractreconstruction,thejejunumwithsuitablesutureli2gatedat2cmdistaltoside2to2endjejunoduodenostomywaschangedtosewup2-3needlesandtonarrowit.End2to2sideesophagojejunostomytoTreitzligamentwasshortenedto20-25cmbefittingly.Side2to2sidejejunojejunosto2mytoTreitzligamentwas10cm.Bothe
6、sophagojejunostomyandjejunojejunostomymustnotbetensioned.ResultsNopatientsdiedorhadanastomoticleakageinperioperativeperiod.Roux2en2Ystasissyndrome(RSS)wasin2patients.TheVisickgrade:35patientsweregradeⅠ,3patientsweregradeⅡ.Serumnutritionalparametersin2patientshemoglobinwasonlylowerthannorm
7、al.At6monthsafteroperation,foodintakepermealandbodyweightwererecoveredtothepreoperativelevelin36patients,andonly2patientsappearedweightworse.Onepatienthadrefluxesophagitisandnodumpingsyndromeoccurred.Throughtheuppergastrointestinalradiograph,thebariumsenteredintoduo
