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目的探讨保留幽门间置顺蠕动空肠的胃次全切术治疗贲门癌的可行性。方法对我院31例贲门癌行保留幽门的胃次全切除术。在食管与残胃之间间置顺蠕动空肠,并在食管空肠吻合口下方3 cm左右重叠缝合空肠浆肌层重建人工贲门。结果31例贲门癌患者均随访1～8年,平均(2.4±0.5)年。随访患者的胃排空时间为(2.2±0.4)h,无贫血、倾倒综合征发生;食管及吻合口炎症2例。保留幽门间置顺蠕动空肠的胃次全切术后残胃具有贮存食物、良好的排空及抗返流功能,患者术后生存质量满意。结论本术式术后并发症少,反流性食管炎发生率低,患者生活质量明显提高。
Objective To investigate the feasibility of gastric subtotal gastrectomy for preserving gastric cardia carcinoma with pyloric interposition of peristalsis. Methods 31 cases of gastric cardia cancer hospital reservation pyloric subtotal gastrectomy. Between the esophagus and residual gastric peristalsis between the peristalsis jejunum, and esophagogastrostomy anastomosis below about 3 cm overlapping suture of jejunal muscle reconstruction of artificial cardia. Results 31 patients with cardiac cancer were followed up for 1 to 8 years, with an average of (2.4 ± 0.5) years. Follow-up of patients with gastric emptying time (2.2 ± 0.4) h, no anemia, dumping syndrome occurred; esophageal and anastomotic inflammation in 2 cases. Preservation of pyloric cistern peristalsis of the stomach after subtotal gastrectomy with food storage, good emptying and anti-reflux function, postoperative quality of life of patients satisfied. Conclusion This procedure less postoperative complications, reflux esophagitis incidence is low, patients with significantly improved quality of life.