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当次全胃切除术不能充分清除胃的恶性病变时,需要作全胃切除术(约占胃癌的20％—40％)。业已证实,切除界限距肿瘤边缘至少10cm可获最佳效果。根据病变部位,可能需要切除食管末端或十二指肠第一部分。100年来的文献介绍了各种代胃术对病理生理学和营养的影响。1922年Hoffmann创造了在空肠输入和输出襻之间充足的肠肠吻合术,这种方法在1945年和1949年曾被推荐,但大多数病人发生了持久的返流性食管炎。将部分回结肠或横结肠插入食管和十二指肠之间也不能令人满意。也有人折襞3个空肠襻建造
When total gastrectomy fails to adequately remove the malignant lesions of the stomach, a total gastrectomy (about 20% to 40% of gastric cancer) is required. It has been confirmed that the best effect can be achieved when the resection margin is at least 10 cm from the edge of the tumor. Depending on the lesion, it may be necessary to resect the end of the esophagus or the first part of the duodenum. The literature for the past 100 years has described the effects of various gastrostomy procedures on pathophysiology and nutrition. In 1922, Hoffmann created an enteroenterostomy between the jejunum input and the output fistula. This method was recommended in 1945 and 1949, but most patients developed persistent reflux esophagitis. Inserting part of the ileocolic or transverse colon between the esophagus and the duodenum was also unsatisfactory. Some people also folded three jejunums to build