Rea Teresa, Bartolacci Mauro, Leombruni Edoardo, Brizzi Felice, Picardi Nicola
Università degli Studi "G. d'Annunzio", Dipartimento di Scienze Chirurgiche Cliniche e Sperimentali, P.O. "SS. Annunziata", I Divisione Clinicizzata di Chirurgia.
Ann Ital Chir. 2005 Jul-Aug;76(4):343-51.
The Roux-en-Y recostruction after total or subtotal gastrectomy for gastric cancer is frequently performed to prevent esophageal alkaline reflux. Also after total gastrectomy and end-to-side gastrojejunal anastomosis, as usual in former experience, the alkaline reflux can be efficaciously treated by conversion in an esophago-jejunal Roux-en-Y procedure. The main factor preventing reflux is the length of jejunal loop, at least of 35-40 cm. The recostruction with a Roux-en-Y jejunal loop offers the advantage to meet together two primary requirements: the restoration of digestive travel from esophagus to intestine, and the prevention of on alcaline reflux esophagitis, both with relevant simplicity and without a time-consuming surgical technique. Also as a consequence the postoperative morbidity is decreased. The obvious suitable requirement is a sufficient lenght of the jejunal loop for a reservoir of the ingested food and to oppose the antiperistaltic jejunal movements thanks to the effects of the new activated jejunal pace-maker.
胃癌全胃或次全胃切除术后常采用Roux-en-Y重建术来预防食管碱性反流。同样，在全胃切除并进行端侧胃空肠吻合术后，按照以往经验，通过将其转换为食管空肠Roux-en-Y手术，碱性反流可得到有效治疗。防止反流的主要因素是空肠袢的长度，至少为35 - 40厘米。采用Roux-en-Y空肠袢重建术具有优势，它能同时满足两个主要要求：恢复从食管到肠道的消化行程，以及预防碱性反流性食管炎，操作相对简单，且无需耗时的手术技术。因此，术后发病率也会降低。明显合适的要求是有足够长度的空肠袢，以储存摄入的食物，并借助新激活的空肠起搏器的作用对抗空肠的逆蠕动。
