Blunschi T, Schweizer W, Gertsch P, Blumgart L H
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Zentralbl Chir. 1991;116(2):105-15.
53 patients submitted to gastric resection and reconstruction either by means of Roux-en-Y gastrojejunostomy, Billroth I or Billroth II operation were followed for a mean of three years and compared for clinical status using the Visick grading system, dumping grading after the method of Sigstad, and careful clinical questioning regarding post-gastrectomy symptoms. Personal follow up by the same examiner corresponding to a standardized questionnaire and the objective grading revealed that our results for individual operations compared well with the reports of other studies investigating mostly only one type of operation for one criterion. However, the Roux-en-Y reconstruction showed significantly better results when compared to Billroth I and especially Billroth II reconstruction. It is concluded that partial gastrectomy with Roux-en-Y reconstruction is the preferred approach provided that, in the light of the pathology encountered at operation, the procedure is technically feasible and adequate.
53例行胃切除术并采用Roux-en-Y胃空肠吻合术、毕罗Ⅰ式或毕罗Ⅱ式手术进行重建的患者接受了平均三年的随访,并使用Visick分级系统、Sigstad法的倾倒分级以及关于胃切除术后症状的仔细临床询问对临床状况进行了比较。由同一位检查者根据标准化问卷进行的个人随访和客观分级显示,我们针对个体手术的结果与其他大多仅针对一种手术类型的一项标准进行研究的报告相比情况良好。然而,与毕罗Ⅰ式尤其是毕罗Ⅱ式重建相比,Roux-en-Y重建显示出明显更好的结果。得出的结论是,只要根据手术中遇到的病理情况,该手术在技术上可行且充分,那么采用Roux-en-Y重建的部分胃切除术就是首选方法。