Liu D H
China Japan Friendship Hospital, Beijing.
Zhonghua Wai Ke Za Zhi. 1990 May;28(5):258-60, 316.
In this report, four different procedures were adopted to reconstruct the alimentary tract after total gastrectomy performed for gastric carcinoma in 92 cases. They were end to side (or end to end) esophagojejunostomy (48 cases), rho-shaped esophagojejunostomy (28 cases), and end to end esophagoduodenostomy (16 cases). The incidence of anastomotic leakage was 4.3%, the operative mortality 2.2%. No anastomotic leakage occurred in the rho-shaped esophagojejunostomy group which is considered to be safe and effective. Though end to end esophagoduodenostomy has the advantage of being simple and time sparing, it can not be applied to all patients for the tension at the site of anastomosis. It might be indicated when the tumor is located in the greater or lesser curvature with the cardiac or pyloric end not involved, or when the distance between the lower end of the esophagus and the upper border of duodenum cone is not larger than the width of 1.5 vertebral body.
本报告中，对92例因胃癌行全胃切除术后的患者采用了四种不同的消化道重建方法。它们分别是端侧（或端端）食管空肠吻合术（48例）、Roux-en-Y食管空肠吻合术（28例）和端端食管十二指肠吻合术（16例）。吻合口漏发生率为4.3%，手术死亡率为2.2%。Roux-en-Y食管空肠吻合术组未发生吻合口漏，该方法被认为安全有效。虽然端端食管十二指肠吻合术具有操作简单、节省时间的优点，但由于吻合部位存在张力，并非适用于所有患者。当肿瘤位于大弯或小弯且未累及贲门或幽门端，或食管下端与十二指肠球部上缘之间的距离不超过1.5个椎体宽度时，可考虑采用该方法。
