Department of Surgery, Division of Gastroenterology, National Hospital Organization Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan.
Surg Today. 2012 Nov;42(11):1135-8. doi: 10.1007/s00595-012-0212-y. Epub 2012 Jun 12.
Surgery for gastric remnant cancer after distal gastrectomy is well established; however, little is known about the removal of remnant gastric cancer following proximal gastrectomy with jejunal interposition. We introduce a surgical technique for removing remnant cancer under these circumstances. We used this technique to remove a total gastric remnant with radical lymph node dissection, while preserving the interposed jejunum for easy re-reconstruction by Roux-en-Y anastomosis, in five patients. The median operating time was 199 min and the median blood loss was 330 ml. There were no postoperative deaths or major complications and all five patients were discharged within 14 days after surgery. Our technique for total resection of the gastric remnant after proximal gastrectomy and re-reconstruction with preserved interposed jejunum is easy, safe, and effective.
胃大部切除术后残胃癌的外科治疗已得到广泛认可；然而，对于胃上部切除术后采用空肠间置术治疗残胃癌的方法知之甚少。我们在此介绍一种此类情况下的手术技术。我们采用该技术为五例患者施行全胃残胃癌根治性淋巴结清扫术，同时保留间置空肠，便于通过 Roux-en-Y 吻合术进行再次重建。中位手术时间为 199 分钟，中位出血量为 330 毫升。术后无死亡或重大并发症发生，所有患者均在术后 14 天内出院。我们采用的胃上部切除术后全胃残胃癌根治性切除及保留间置空肠再次重建的技术简便、安全、有效。
