Kikuchi Shiro, Nemoto Yuhta, Katada Natsuya, Sakuramoto Shinichi, Kobayashi Nobuyuki, Shimao Hitoshi, Watanabe Masahiko
Department of Surgery, School of Medicine, Kitasato University, Kanagawa Japan.
Hepatogastroenterology. 2007 Jan-Feb;54(73):304-7.
BACKGROUND/AIMS: The present study evaluates the findings of long-term follow-up endoscopy in patients who underwent proximal gastrectomy with jejunal interposition for gastric cancer.
A total of 55 patients (45 males, 10 females; 32 to 79 years; mean, 55.9 years), who underwent proximal gastrectomy with jejunal interposition, were enrolled in the present study. We reviewed the findings of follow-up endoscopy of all patients with particular reference to the development of esophagitis, jejunitis, jejunal ulcer and secondary tumors.
We found reflux esophagitis in 6 patients (10.9%) between 12 and 35 months with an average of 22 months after surgery. Jejunitis was discovered in 5 patients (9.0%) between 6 and 96 months with an average of 29 months after surgery. Jejunal ulcer was revealed in 6 patients (10.9%) between 6 and 75 months with an average of 37 months after surgery. Tumors of the remnant stomach, early gastric cancer and gastric adenoma, were identified in 2 patients (3.6%) at 24 months and 69 months, respectively.
Jejunal interposition combined with proximal gastrectomy does not always prevent complications related to regurgitation of gastric content, and may not be a suitable treatment in view of postoperative endoscopic surveillance. Further studies are required to identify an appropriate surgical approach to proximal gastrectomy for gastric cancer.
背景/目的：本研究评估了接受近端胃切除术并空肠间置术治疗胃癌患者的长期随访内镜检查结果。
本研究纳入了55例接受近端胃切除术并空肠间置术的患者（45例男性，10例女性；年龄32至79岁；平均55.9岁）。我们回顾了所有患者的随访内镜检查结果，特别关注食管炎、空肠炎、空肠溃疡和继发性肿瘤的发生情况。
我们发现6例患者（10.9%）在术后12至35个月（平均22个月）出现反流性食管炎。5例患者（9.0%）在术后6至96个月（平均29个月）发现空肠炎。6例患者（10.9%）在术后6至75个月（平均37个月）出现空肠溃疡。分别在术后24个月和69个月发现2例患者（3.6%）出现残胃癌、早期胃癌和胃腺瘤。
空肠间置术联合近端胃切除术并不能总是预防与胃内容物反流相关的并发症，从术后内镜监测的角度来看，可能不是一种合适的治疗方法。需要进一步研究以确定适合胃癌近端胃切除术的手术方式。
