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重建方法对胃大部切除术后残胃食物潴留现象的影响。

The influence of reconstruction methods on food retention phenomenon in the remnant stomach after a subtotal gastrectomy.

作者信息

Jung Hyung Joong, Lee Jun Ho, Ryu Keun Won, Lee Jong Yeul, Kim Chan Gyoo, Choi Il Ju, Kim Young-Woo, Bae Jae Moon

机构信息

Center for Gastric Cancer, National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea.

出版信息

J Surg Oncol. 2008 Jul 1;98(1):11-4. doi: 10.1002/jso.21076.

Abstract

BACKGROUND AND OBJECTIVES

Food retention and bile reflux has been frequently observed in gastric cancer patients following a subtotal gastrectomy. The aim of this study was to determine whether reconstruction methods after the distal subtotal gastrectomy influenced the degree of food residue and bile reflux.

METHODS

The prospectively collected data was reviewed retrospectively for 522 patients with early gastric cancer who had undertaken a follow-up endoscopic examination after a distal subtotal gastrectomy between 2003 and 2006.

RESULTS

The incidence of food retention was 55.5%, 31.9%, and 20.9% at 3, 12, and 24 months after distal subtotal gastrectomy, respectively. The food residue score was higher in the Billroth I (stapling) group than the Billroth II (hand sewing) group at 3 months after surgery (P = 0.006). The incidence of bile reflux was higher in the Billroth II group than in the Billroth I group at 12 and 24 months after surgery (P < 0.001, P = 0.002, respectively). No significant association was found between the food retention and body weight changes.

CONCLUSIONS

Food retention was detected in lots of patients after subtotal gastrectomy and the reconstructive methods after subtotal gastrectomy was not relevant to food retention.

摘要

背景与目的

在胃癌患者接受胃大部切除术后,经常观察到食物潴留和胆汁反流现象。本研究的目的是确定远端胃大部切除术后的重建方法是否会影响食物残渣和胆汁反流的程度。

方法

回顾性分析2003年至2006年间接受远端胃大部切除术并进行了随访内镜检查的522例早期胃癌患者的前瞻性收集数据。

结果

远端胃大部切除术后3、12和24个月时,食物潴留的发生率分别为55.5%、31.9%和20.9%。术后3个月时,毕Ⅰ式(吻合器吻合)组的食物残渣评分高于毕Ⅱ式(手工缝合)组(P = 0.006)。术后12个月和24个月时,毕Ⅱ式组的胆汁反流发生率高于毕Ⅰ式组(分别为P < 0.001,P = 0.002)。未发现食物潴留与体重变化之间存在显著关联。

结论

胃大部切除术后许多患者存在食物潴留现象,且胃大部切除术后的重建方法与食物潴留无关。

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